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General NPI Number Information
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NPI Number | 1245700335
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Entity Type | Individual
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Provider Name | PHILLIP ABRAM GARNER OT
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Gender | Male
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 11/30/2018
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Provider Practice Location Address
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Address Line | 201 W CRANE ST
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City | NORTON
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State | KS
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Zip | 67654-1117
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Country | US
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Telephone | 785-877-5120
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Fax |
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Provider Business Mailing Address
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Address Line | 787 MOTT HILL RD
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City | SOUTH GLASTONBURY
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State | CT
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Zip | 06073-3625
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Country | US
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Telephone | 910-584-9162
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 17-03493
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License Number State | KS
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