Healthcare Provider Details

I. General information

NPI: 1235902685
Provider Name (Legal Business Name): GARRETT SEEGERS PTA, CLT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

345 JUPITER LAKES BLVD STE 300
JUPITER FL
33458-7100
US

IV. Provider business mailing address

900 CHURCHILL RD
WEST PALM BEACH FL
33405-3413
US

V. Phone/Fax

Practice location:
  • Phone: 561-529-2213
  • Fax: 561-529-2544
Mailing address:
  • Phone: 561-632-4774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number32027
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: