Provider Demographics
NPI:1992911572
Name:GARRETT, TROY RICHARD (ATC)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:RICHARD
Last Name:GARRETT
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 CHERRYWOOD PL
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-1621
Mailing Address - Country:US
Mailing Address - Phone:319-268-8182
Mailing Address - Fax:
Practice Address - Street 1:2351 HUDSON RD
Practice Address - Street 2:UNI - HPC 008A
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50614-0065
Practice Address - Country:US
Practice Address - Phone:319-273-7448
Practice Address - Fax:319-273-7023
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA6352255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer