MEDICARE: GARRETT THURMAN APC

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	101YM0800X	Mental Health Counselor	APC007288	GA

General Provider Information

NPI Number	:	1659099521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARRETT THURMAN APC

Provider Business Mailing Address
First Line	:	3082 KENTMERE DR
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-1220
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	314 TRIBBLE GAP RD STE B
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-2475
Country	:	US
Telephone Number	:	678-772-2343
Fax Number	:

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

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	08/17/2022

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