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NPI Code Detail

MEDICARE: MISS TANIA LYNN GARRANT MPT

MEDICARE:  MISS TANIA LYNN GARRANT  MPT
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 Therapist5501011739MI

General Provider Information

NPI Number : 1790704609
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS TANIA LYNN GARRANT MPT
Provider Business Mailing Address
First Line : 42867 POTOMAC
Second Line :
City : NOVI
State : MI
Zip : 48375-1769
Country : US
Telephone Number : 248-668-9355
Fax Number : 248-668-9351
Provider Business Practice Location Address
First Line : 55 N POND DR
Second Line : SUITE 4
City : WALLED LAKE
State : MI
Zip : 48390-3080
Country : US
Telephone Number : 248-668-9355
Fax Number : 248-668-9351
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/08/2007

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Directions to “ MISS TANIA LYNN GARRANT MPT” Practice Location

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