Individual
TYLER GARDINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
119 GANNETT DR, SOUTH PORTLAND, ME 04106-6942
(207) 773-0040
Mailing address
61 GREEN ST, WATERTOWN, MA 02472-2351
(617) 924-3794
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT881
ME
Other
Enumeration date
05/18/2020
Last updated
06/23/2022
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