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NPI Code Detail

MEDICARE: TARA MARIE GARVIN OTR/L

MEDICARE: TARA MARIE GARVIN OTR/L
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
1225X00000XOccupational Therapist4041AL

General Provider Information

NPI Number : 1992172282
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA MARIE GARVIN OTR/L
Provider Business Mailing Address
First Line : 245 CAHABA VALLEY PKWY
Second Line :
City : PELHAM
State : AL
Zip : 35124-2216
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2004 MAX LUTHER DR NW
Second Line :
City : HUNTSVILLE
State : AL
Zip : 35810-3800
Country : US
Telephone Number : 205-942-6820
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2015
Last Update Date : 10/05/2015

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