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General NPI Number Information
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NPI Number | 1255304424
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Entity Type | Individual
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Provider Name | KEITH GARNETT MS, ATC, LAT, PES
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 333 E TRADE ST
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City | CHARLOTTE
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State | NC
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Zip | 28202-2425
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Country | US
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Telephone | 704-688-8998
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Fax | 704-688-8726
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Provider Business Mailing Address
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Address Line | 836 E REDWOOD ST
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City | SPRINGFIELD
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State | MO
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Zip | 65807-5172
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Country | US
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Telephone | 704-968-9734
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Fax | 704-688-8725
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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