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Individual

DR. KEVIN E GARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT, OCS

Contact information

Practice address
1601 CHERRY ST, MS 21041, PHILADELPHIA, PA 19102-1320
(215) 553-7012
(215) 553-7019
Mailing address
1601 CHERRY ST, MS 21041, PHILADELPHIA, PA 19102-1320
(215) 553-7012
(215) 553-7019

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT007722L
PA
2251X0800X
Orthopedic Physical Therapist
Primary
PT007722L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001849289
PA
01
00184928904
AMERICHOICE
PA
01
1140267
FIRST HEALTH
PA
01
20035880
AMERIHEALTH MERCY
PA
01
231352630
HORIZON BC/BS
NJ
01
231352630
TRICARE
PA
01
3054832
AETNA
PA
01
815693
BC/BS
PA
01
P2979020
OXFORD
PA
01
XY4653
HEALTH NET
PA
Enumeration date
02/17/2006
Last updated
01/13/2017
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