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NPI Code Detail

MEDICARE: CHRISTOPHER G GARAVITO MPT

MEDICARE: CHRISTOPHER G GARAVITO MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist6334SC

General Provider Information

NPI Number : 1285931725
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER G GARAVITO MPT
Provider Business Mailing Address
First Line : 4125 DICK POND RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-6807
Country : US
Telephone Number : 843-999-0284
Fax Number :
Provider Business Practice Location Address
First Line : 4125 DICK POND RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29588-6807
Country : US
Telephone Number : 843-999-0284
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/18/2011
Last Update Date : 04/25/2019

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Directions to “ CHRISTOPHER G GARAVITO MPT” Practice Location

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