Individual
MELISSA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1901 HOWELL AVE, WORLAND, WY 82401-3733
(307) 347-4285
Mailing address
PO BOX 374, RIVERTON, WY 82501-0075
(307) 851-0859
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA300
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0859
—
WY
Enumeration date
12/06/2021
Last updated
12/06/2021
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