Provider Demographics
NPI:1386421188
Name:GARVEY, PATRICK NELSON (PTA)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:NELSON
Last Name:GARVEY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2075 N 133RD AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-8600
Mailing Address - Country:US
Mailing Address - Phone:602-601-9331
Mailing Address - Fax:
Practice Address - Street 1:1382 S COTTON LN
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-4657
Practice Address - Country:US
Practice Address - Phone:520-438-7090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-13
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ014574225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant