Individual
SCOTT GREGORY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
4080 W BROADWAY AVE, SUITE 300, ROBBINSDALE, MN 55422-5604
(763) 520-0167
Mailing address
9483 MINNESOTA LN N, MAPLE GROVE, MN 55369-4446
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1236
A.T. REGISTRATION
MN
Enumeration date
12/22/2006
Last updated
07/08/2007
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