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Individual
MR. SCOTT WILLIAM GARDNER
Active
Individual
MR. SCOTT WILLIAM GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1119
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AT1119
DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
SC
Enumeration date
02/06/2006
Last updated
05/01/2023
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