Individual
MISTY D GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, DPT
Contact information
Practice address
1333 W 5TH ST, SUITE 203, SHERIDAN, WY 82801-2752
(307) 752-9335
Mailing address
PO BOX 306, BIG HORN, WY 82833-0306
(307) 752-9335
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT1154
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123365300
—
WY
Enumeration date
07/30/2006
Last updated
12/05/2011
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