Individual
DAVE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1781 NORTH COMMONS LOOP, TUSCALOOSA, AL 35406-3577
(205) 752-0845
(205) 752-0866
Mailing address
1781 NORTH COMMONS LOOP, TUSCALOOSA, AL 35406-3577
(205) 752-0845
(205) 752-0866
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTH763
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
51527979
BCBS PROVIDER NUMBER
AL
01
—
PTA763
ALABAMA PT LICENSE NUMBER
AL
Enumeration date
05/24/2007
Last updated
01/03/2013
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