MEDICARE: ANGELICA LEIGH GARRETT PT

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	05008749A	IN

General Provider Information

NPI Number	:	1750601522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELICA LEIGH GARRETT PT

Provider Business Mailing Address
First Line	:	223 LEGACY LN
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46032-1635
Country	:	US
Telephone Number	:	317-331-8459
Fax Number	:

Provider Business Practice Location Address
First Line	:	10601 N MERIDIAN ST
Second Line	:	STE 110
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46290-1152
Country	:	US
Telephone Number	:	317-575-2100
Fax Number	:

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

Provider Enumeration Date	:	06/03/2010
Last Update Date	:	04/12/2013

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