Individual
PAUL MATTHEW GARDNER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
2380 8TH AVE, SUITE 8, PLATTSMOUTH, NE 68048-2367
(402) 296-3433
(402) 296-3531
Mailing address
2380 8TH AVE, SUITE 8, PLATTSMOUTH, NE 68048-2367
(402) 296-3433
(402) 296-3531
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1922
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0581362
—
IA
01
—
08797
BLUE CROSS BLUE SHIELD
NE
Enumeration date
11/14/2005
Last updated
07/09/2007
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