Individual
ALYSSA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6301 BASS RD, PROSPECT, KY 40059-9384
(812) 508-1660
Mailing address
453 STATE ROAD 60 W, MITCHELL, IN 47446-5601
(812) 508-1660
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06006260A
IN
225200000X
Physical Therapy Assistant
Primary
A04234
KY
Other
Enumeration date
08/02/2021
Last updated
08/02/2021
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