Provider Demographics
NPI:1316297138
Name:GARCIA, JOSE MANUEL (BSW)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:GARCIA
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 WHEELER RD
Mailing Address - Street 2:
Mailing Address - City:SNOVER
Mailing Address - State:MI
Mailing Address - Zip Code:48472-9303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:876 N VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-9016
Practice Address - Country:US
Practice Address - Phone:989-623-0137
Practice Address - Fax:989-921-4977
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other