Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 05007326A | IN |
NPI | 1053459636 |
---|---|
Provider Name | Ms. Sarah Garrett |
First Address | Lebanon, IN 46052-9171 |
Second Address | Lebanon, IN 46052-9171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2007 |
Last Update Date | 08/07/2007 |