MEDICARE: KENDRA GARRETT PT, DPT, WCS

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
1	225100000X	Physical Therapist	1256357	TX

General Provider Information

NPI Number	:	1942827894
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENDRA GARRETT PT, DPT, WCS

Provider Business Mailing Address
First Line	:	6465 COLLEGE PARK SQ STE 312
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3609
Country	:	US
Telephone Number	:	757-572-0183
Fax Number	:

Provider Business Practice Location Address
First Line	:	6465 COLLEGE PARK SQ STE 312
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23464-3609
Country	:	US
Telephone Number	:	757-572-0183
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2020
Last Update Date	:	07/22/2025

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