Provider Demographics
NPI:1912727686
Name:FARMERIE, GARRETT (MS, LAT, ATC)
Entity type:Individual
Prefix:
First Name:GARRETT
Middle Name:
Last Name:FARMERIE
Suffix:
Gender:M
Credentials:MS, LAT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5715 CEDAR WALK APT 404
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20121-4535
Mailing Address - Country:US
Mailing Address - Phone:703-470-0891
Mailing Address - Fax:
Practice Address - Street 1:5715 CEDAR WALK APT 404
Practice Address - Street 2:
Practice Address - City:CENTREVILLE
Practice Address - State:VA
Practice Address - Zip Code:20121-4535
Practice Address - Country:US
Practice Address - Phone:703-470-0891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0126003643207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine