Individual
GREGORY J GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9350 S 150 E, #460, SANDY, UT 84070-2702
(801) 255-4999
(801) 748-1865
Mailing address
9350 S 150 E, #460, SANDY, UT 84070-2702
(801) 255-4999
(801) 748-1865
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
104149-2401
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104149-2401
STATE LICENSE
UT
Enumeration date
06/16/2005
Last updated
07/08/2007
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