Healthcare Provider Details

I. General information

NPI: 1770609638
Provider Name (Legal Business Name): JAMES JUSTIN GARNER PT,MPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 11/17/2025
Certification Date: 11/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 CLINTON PKWY
CLINTON MS
39056-4730
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 601-926-2018
  • Fax: 601-924-9746
Mailing address:
  • Phone: 901-226-4003
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number07014
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT4201
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: