Healthcare Provider Details

I. General information

NPI: 1336372507
Provider Name (Legal Business Name): CATHERINE GARWACKI DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2009
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 SAMMY MCGHEE BLVD STE 204
JASPER GA
30143-7712
US

IV. Provider business mailing address

730 N NORMA ST
RIDGECREST CA
93555-3521
US

V. Phone/Fax

Practice location:
  • Phone: 762-362-8405
  • Fax:
Mailing address:
  • Phone: 760-384-4441
  • Fax: 760-384-4442

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPT016377
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: