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General NPI Number Information
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NPI Number | 1629293519
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Entity Type | Individual
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Provider Name | STACIE LEE GARNER P. T.
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Gender | Female
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 07/21/2008
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Provider Practice Location Address
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Address Line | 120 W CERRITOS AVE BUIDING 3
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City | ANAHEIM
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State | CA
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Zip | 92805-6546
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Country | US
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Telephone | 714-991-4900
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Fax | 714-991-4901
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Provider Business Mailing Address
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Address Line | 120 W CERRITOS AVE BUILDING 3
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City | ANAHEIM
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State | CA
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Zip | 92805-6546
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Country | US
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Telephone | 714-991-4900
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Fax | 714-991-4901
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29768
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License Number State | CA
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