Todd A Gardner, PTA
Individual provider Active NPI Physical Therapy Assistant · West Bountiful, UT
NPI 1285963777 · NPPES record last updated Dec 14, 2009
Key facts
- NPI
- 1285963777
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2852642402 (UT)
- Practice address
- 2233 North 830 West
West Bountiful, UT 84087 - Phone
- (801) 916-6566
- Fax
- (801) 295-6568
- NPI assigned
- Dec 14, 2009
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA-266 | ID | MD | Physical Therapy Assistant |
| 2852642402 | UT | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2852642402 | UT | Yes |
| Physical Therapy Assistant | 225200000X | PTA-266 | ID |
Addresses
Primary practice location
2233 North 830 West
West Bountiful, UT 84087
Mailing address
2233 North 830 West
West Bountiful, UT 84087
Phone (801) 916-6566
Other providers in West Bountiful, UT
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- Jennifer Chase
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- Rachel Cottle
- April Michelle Gray
- Maren Hansen
- Erika Susanne Hardy
- Joseph Vincent Lodrick
- Mardee Olpin Merrill
All providers in West Bountiful, UT · Physical Therapy Assistant in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.