Individual
SHAWN GARDINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 W BREWSTER ST, APPLETON, WI 54914-1699
(920) 832-1657
Mailing address
913 WILSON AVE, GREEN BAY, WI 54303-4109
(920) 386-2686
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2386-019
WI
Other
Enumeration date
08/31/2015
Last updated
08/31/2015
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