Individual
DYLAN JERAMIAH GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2614 W 42ND ST, SCOTTSBLUFF, NE 69361-4802
(308) 630-0600
Mailing address
2008 AVENUE B, SCOTTSBLUFF, NE 69361-1941
(308) 632-8016
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
09/17/2025
Last updated
10/24/2025
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