Provider Demographics
NPI:1649036583
Name:GARRARD, DAVID WAYNE (BHS, RRT, LRT, RCP)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:GARRARD
Suffix:
Gender:M
Credentials:BHS, RRT, LRT, RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:532 W COLORADO AVE APT 409
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-1553
Mailing Address - Country:US
Mailing Address - Phone:340-474-1433
Mailing Address - Fax:719-546-4219
Practice Address - Street 1:532 W COLORADO AVE APT 409
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-1553
Practice Address - Country:US
Practice Address - Phone:340-474-1433
Practice Address - Fax:719-546-4219
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI2279P4000X
CO2279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
No2279P4000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPatient Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC42830OtherNBRC
CORTL.0006145OtherCOLORADO DORA