Individual
BRENT MICHAEL GARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 APEX DR, HIGHLAND, IL 62249-1282
(618) 651-0444
Mailing address
15 APEX DR, HIGHLAND, IL 62249-1282
(618) 651-0444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.017197
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205983004
PTAN
IL
Enumeration date
11/03/2009
Last updated
01/27/2010
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