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General NPI Number Information
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NPI Number | 1811787138
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Entity Type | Individual
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Provider Name | LANDRY GARRISON DPT
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Gender | Female
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Dates
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Enumeration Date | 05/09/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 2000 MIRROR LAKE BLVD STE S
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City | VILLA RICA
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State | GA
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Zip | 30180-2126
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Country | US
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Telephone | 770-456-7877
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Fax | 770-456-7880
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Provider Business Mailing Address
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Address Line | 2000 MIRROR LAKE BLVD STE S
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City | VILLA RICA
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State | GA
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Zip | 30180-2126
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Country | US
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Telephone | 770-456-7877
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Fax | 770-456-7880
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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 | PT017728
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License Number State | GA
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