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General NPI Number Information
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NPI Number | 1992212682
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Entity Type | Individual
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Provider Name | BARON GRAY GARNER OTR/L
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Gender | Male
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Dates
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Enumeration Date | 01/04/2018
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Last Update Date | 01/04/2018
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Provider Practice Location Address
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Address Line | 1150 MARSH STREET
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City | TAPPAHANNOCK
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State | VA
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Zip | 22560
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Country | US
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Telephone | 804-443-4308
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Fax |
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Provider Business Mailing Address
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Address Line | 3996 IRON BRIDGE RD
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City | LAWRENCEVILLE
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State | VA
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Zip | 23868-3709
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Country | US
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Telephone | 434-594-5923
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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 | 225XN1300X
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Taxonomy Name | Neurorehabilitation Occupational Therapist
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License Number | 0119006849
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 225XP0019X
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Taxonomy Name | Physical Rehabilitation Occupational Therapist
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License Number | 0119006849
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License Number State | VA
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