Organization
GARNETT REHAB INC
Active
Other names
Connie's Mastectomy Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TWYLA SUZAN GARNETT RPT (PRESIDENT)
(352) 795-5223
Entity
Organization
Contact information
Practice address
6441 W NORVELL BRYANT HWY, CRYSTAL RIVER, FL 34429-9413
(352) 795-5223
(352) 795-6390
Mailing address
6441 W NORVELL BRYANT HWY, CRYSTAL RIVER, FL 34429-9413
(352) 795-5223
(352) 795-6390
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
FL
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7516200001
PTAN
FL
Enumeration date
11/20/2015
Last updated
05/06/2020
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