Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 095744 | IA |
NPI | 1063067510 |
---|---|
Provider Name | Daniel Ray Garnes |
First Address | Fairfield, IA 52556-2492 |
Second Address | Washington, IA 52353-1126 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2019 |
Last Update Date | 01/08/2019 |