Healthcare Provider Details

I. General information

NPI: 1841418399
Provider Name (Legal Business Name): GARRETT CREHAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 HIGH ST
GREENFIELD MA
01301-2702
US

IV. Provider business mailing address

28 CHURCH ST
SHELBURNE FALLS MA
01370-1202
US

V. Phone/Fax

Practice location:
  • Phone: 413-774-5411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: