Provider Demographics
NPI:1275344012
Name:GARRETT, DEWAYNE STEVEN II (DPT)
Entity type:Individual
Prefix:DR
First Name:DEWAYNE
Middle Name:STEVEN
Last Name:GARRETT
Suffix:II
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:PENNINGTON GAP
Mailing Address - State:VA
Mailing Address - Zip Code:24277-0489
Mailing Address - Country:US
Mailing Address - Phone:276-219-3140
Mailing Address - Fax:
Practice Address - Street 1:123 CANE CREEK RD
Practice Address - Street 2:
Practice Address - City:PENNINGTON GAP
Practice Address - State:VA
Practice Address - Zip Code:24277-8033
Practice Address - Country:US
Practice Address - Phone:276-546-1234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305216877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist