Provider Demographics
NPI:1396106985
Name:ALLRED, GARREN (DPT)
Entity type:Individual
Prefix:MR
First Name:GARREN
Middle Name:
Last Name:ALLRED
Suffix:
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 1:245 WINDWARD WAY STE 101
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3385
Mailing Address - Country:US
Mailing Address - Phone:406-756-8488
Mailing Address - Fax:406-758-3234
Practice Address - Street 1:245 WINDWARD WAY STE 101
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3385
Practice Address - Country:US
Practice Address - Phone:406-756-8488
Practice Address - Fax:406-758-3234
Is Sole Proprietor?:No
Enumeration Date:2016-03-10
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDPT-4418225100000X
MTPTP-PT-LIC-20168225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist