Provider Demographics
NPI:1902320948
Name:GARNER, ABIGAIL SIMONE (DPT)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:SIMONE
Last Name:GARNER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13595 ATLANTIC BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32225-3256
Mailing Address - Country:US
Mailing Address - Phone:904-221-4046
Mailing Address - Fax:
Practice Address - Street 1:13595 ATLANTIC BLVD STE B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32225-3256
Practice Address - Country:US
Practice Address - Phone:904-221-4046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT32833225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist