Provider Demographics
NPI:1437426004
Name:GARRETT, FREDERICK KIRBY (TRANSPORTATION)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:KIRBY
Last Name:GARRETT
Suffix:
Gender:M
Credentials:TRANSPORTATION
Other - Prefix:MR
Other - First Name:FREDERICK
Other - Middle Name:KIRBY
Other - Last Name:GARRETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:142 BAKER ST
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-5035
Mailing Address - Country:US
Mailing Address - Phone:540-441-6000
Mailing Address - Fax:
Practice Address - Street 1:308 WILSON ST
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-3022
Practice Address - Country:US
Practice Address - Phone:304-441-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-25
Last Update Date:2011-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2251-8418344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi