Individual
LORRAINE L GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
2101 TRINITY DR, STE. N, LOS ALAMOS, NM 87544-4102
(505) 661-6191
(505) 663-0386
Mailing address
2101 TRINITY DR, STE. N, LOS ALAMOS, NM 87544-4102
(505) 661-6191
(505) 663-0386
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
445
NM
2251E1200X
Ergonomics Physical Therapist
445
NM
2251H1200X
Hand Physical Therapist
445
NM
2251H1300X
Human Factors Physical Therapist
445
NM
2251N0400X
Neurology Physical Therapist
445
NM
2251P0200X
Pediatric Physical Therapist
445
NM
2251S0007X
Sports Physical Therapist
445
NM
2251X0800X
Orthopedic Physical Therapist
445
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00074136
—
NM
01
—
201079804
PRESBYTERIAN HEALTH PLAN
NM
01
—
850448868
ALL OTHER INSURANCIES
NM
01
—
NM00Q036
BLUECROSSBLUESHIELDS
NM
Enumeration date
01/03/2006
Last updated
01/03/2011
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