Provider Demographics
NPI:1891312161
Name:GARLICK, NATHAN (OD)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:GARLICK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 482
Mailing Address - Street 2:BOX 1600
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96362-1600
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL OKINAWA
Practice Address - Street 2:
Practice Address - City:CHATAN
Practice Address - State:NAKAGAMI, OKINAWA
Practice Address - Zip Code:9040103
Practice Address - Country:JP
Practice Address - Phone:979-595-3755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11748989-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist