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NPI Code Detail

MEDICARE: GARRETT CHARLES VAN NUTT DPT

MEDICARE: GARRETT CHARLES VAN NUTT 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
1225100000XPhysical Therapist2305212857VA

General Provider Information

NPI Number : 1790344844
Entity Type Code : Individual
Provider Name (Legal Business Name) : GARRETT CHARLES VAN NUTT DPT
Provider Business Mailing Address
First Line : 1110 VINYARD RD
Second Line :
City : VINTON
State : VA
Zip : 24179-3632
Country : US
Telephone Number : 540-343-0466
Fax Number : 540-345-2261
Provider Business Practice Location Address
First Line : 1110 VINYARD RD
Second Line :
City : VINTON
State : VA
Zip : 24179-3632
Country : US
Telephone Number : 540-343-0466
Fax Number : 540-345-2261
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2019
Last Update Date : 06/12/2019

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