Individual
LISA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
956 CHERRY ST, UTICA, NY 13502-3818
(315) 796-6381
Mailing address
956 CHERRY ST, UTICA, NY 13502-3818
(315) 796-6381
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/15/2016
Last updated
06/15/2016
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