MEDICARE: GARRETT SICARD DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1083565592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRETT SICARD DPT

Provider Business Mailing Address
First Line	:	5111 N RHETT AVE
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-4219
Country	:	US
Telephone Number	:	843-804-9479
Fax Number	:	843-804-9020

Provider Business Practice Location Address
First Line	:	142 SPORTSMAN ISLAND DR
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29492-8524
Country	:	US
Telephone Number	:	843-804-9479
Fax Number	:	843-804-9020

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2026
Last Update Date	:	02/09/2026

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