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Individual

MADELINE ANNE GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MOT, OTR/L

Contact information

Practice address
968 N 4TH ST, BERTHOUD, CO 80513-1142
(303) 250-8425
Mailing address
968 N 4TH ST, BERTHOUD, CO 80513-1142

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0005721
CO

Other

Enumeration date
12/05/2018
Last updated
12/05/2018
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