Provider Demographics
NPI:1144489170
Name:GARNETT, TWYLA SUZAN (PT 17230)
Entity type:Individual
Prefix:MRS
First Name:TWYLA
Middle Name:SUZAN
Last Name:GARNETT
Suffix:
Gender:F
Credentials:PT 17230
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 NE 3RD ST SUITE1
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL RIVER
Mailing Address - State:FL
Mailing Address - Zip Code:34429-3208
Mailing Address - Country:US
Mailing Address - Phone:352-795-5225
Mailing Address - Fax:352-795-6390
Practice Address - Street 1:403 NE 3RD ST SUITE1
Practice Address - Street 2:
Practice Address - City:CRYSTAL RIVER
Practice Address - State:FL
Practice Address - Zip Code:34429-3208
Practice Address - Country:US
Practice Address - Phone:352-795-5225
Practice Address - Fax:352-795-6390
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-05
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT17230225100000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist