Healthcare Provider Details

I. General information

NPI: 1962329599
Provider Name (Legal Business Name): TRENT GARNER LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 BROOKSIDE LN
PALM COAST FL
32137-8721
US

IV. Provider business mailing address

80 BROOKSIDE LN
PALM COAST FL
32137-8721
US

V. Phone/Fax

Practice location:
  • Phone: 828-400-8408
  • Fax:
Mailing address:
  • Phone: 828-400-8408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA15704
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: