MEDICARE: KRYSTAL GARRETT

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	27885	FL
2	225100000X	Physical Therapist		GA

General Provider Information

NPI Number	:	1487181830
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTAL GARRETT

Provider Business Mailing Address
First Line	:	2400 WISTERIA DR STE A
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-2689
Country	:	US
Telephone Number	:	770-982-0102
Fax Number	:	770-982-0130

Provider Business Practice Location Address
First Line	:	1343 W WALNUT AVE
Second Line	:
City	:	DALTON
State	:	GA
Zip	:	30720-3857
Country	:	US
Telephone Number	:	706-913-8201
Fax Number	:	706-459-3646

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

Provider Enumeration Date	:	05/16/2017
Last Update Date	:	06/29/2026

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Directions to “ KRYSTAL GARRETT ” Practice Location

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