Individual
BETHANY GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
196 PHOENETIA DR, ST AUGUSTINE, FL 32086-7338
(386) 341-4310
Mailing address
1409 ROYAL GROVE LN, PORT ORANGE, FL 32129-8998
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH11940
FL
Other
Enumeration date
08/24/2016
Last updated
08/24/2016
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