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NPI Code Detail

MEDICARE: KELSEY GARVERICK

MEDICARE: KELSEY GARVERICK
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
1225X00000XOccupational Therapist7346TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17346OTHERTNTN LICENSE

General Provider Information

NPI Number : 1417683517
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY GARVERICK
Provider Business Mailing Address
First Line : 2276 CANDIES LN NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-2619
Country : US
Telephone Number : 706-271-0100
Fax Number :
Provider Business Practice Location Address
First Line : 2276 CANDIES LN NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-2619
Country : US
Telephone Number : 423-328-8745
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2022
Last Update Date : 07/29/2022

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Directions to “ KELSEY GARVERICK ” Practice Location

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