Garry W. Branson, DPT

Individual provider Active NPI Physical Therapist · Apache Junction, AZ

NPI 1114906930 · NPPES record last updated Mar 27, 2015

Key facts

NPI
1114906930
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
3316 (AZ)
Practice address
850 S Ironwood Dr
Suite 112
Apache Junction, AZ 85120-6242
Phone
(480) 983-1680
Fax
(480) 983-1681
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
RPT754IDMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 3316 AZ Yes
Physical Therapist 225100000X RPT754 ID

Addresses

Primary practice location

850 S Ironwood Dr
Suite 112
Apache Junction, AZ 85120-6242

Mailing address

850 S Ironwood Dr
Suite 112
Apache Junction, AZ 85120-6242
Phone (480) 983-1680

Other identifiers

IdentifierTypeStateIssuer
943337052OtherAZTRICARE/LIFE/STANDARD
1679852289OtherAZBCBS
943337052OtherAZDVA

Other providers in Apache Junction, AZ

All providers in Apache Junction, AZ · Physical Therapist in Arizona

Sources for this page

Verify at the official NPI Registry.