Provider Demographics
NPI:1043308117
Name:GARNER, KRISTIN MAZZEO (PT)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:MAZZEO
Last Name:GARNER
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:2789 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179
Mailing Address - Country:US
Mailing Address - Phone:615-595-8423
Mailing Address - Fax:615-595-8423
Practice Address - Street 1:1647 MALLORY LN
Practice Address - Street 2:SUITE 103
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-2909
Practice Address - Country:US
Practice Address - Phone:615-661-5437
Practice Address - Fax:615-309-8342
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2009-03-31
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN6483225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist