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General NPI Number Information
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NPI Number | 1942521877
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Entity Type | Organization
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Legal Business Name | VIRGINIA GARRETT INC
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 04/25/2014
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Provider Practice Location Address
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Address Line | 3737 MCCRAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92506-2928
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Country | US
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Telephone | 951-823-0266
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Fax | 951-823-0266
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Provider Business Mailing Address
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Address Line | 3737 MCCRAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92506-2928
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Country | US
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Telephone | 951-823-0266
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Fax | 951-823-0266
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIRGINIA ELLEN GARRETT
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Credential | M.D.
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Telephone | 951-823-0266
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 35049101
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License Number State | OH
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