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General NPI Number Information
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NPI Number | 1154132447
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Entity Type | Organization
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Legal Business Name | DR NICOLE GARLIT PHYSICAL THERAPY AND WELLNESS INC
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 3241 GRAND AVE
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City | OAKLAND
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State | CA
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Zip | 94610-2740
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Country | US
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Telephone | 707-596-3396
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Fax |
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Provider Business Mailing Address
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Address Line | 1611 SYCAMORE AVE UNIT 5098
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City | HERCULES
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State | CA
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Zip | 94547-6003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE ASHLEY MAPALO GARLIT
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Credential |
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Telephone | 707-596-3396
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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