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General NPI Number Information
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NPI Number | 1750601522
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Entity Type | Individual
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Provider Name | ANGELICA LEIGH GARRETT PT
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Gender | Female
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Dates
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Enumeration Date | 06/03/2010
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Last Update Date | 04/12/2013
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Provider Practice Location Address
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Address Line | 10601 N MERIDIAN ST STE 110
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City | INDIANAPOLIS
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State | IN
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Zip | 46290-1152
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Country | US
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Telephone | 317-575-2100
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Fax |
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Provider Business Mailing Address
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Address Line | 223 LEGACY LN
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City | CARMEL
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State | IN
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Zip | 46032-1635
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Country | US
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Telephone | 317-331-8459
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05008749A
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License Number State | IN
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