Kylee Gardner, PTA
Individual provider Active NPI Physical Therapy Assistant · Fennimore, WI
NPI 1992402184 · NPPES record last updated Feb 19, 2025
Key facts
- NPI
- 1992402184
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 3306-19 (WI)
- Practice address
- 1850 11TH St
Fennimore, WI 53809-1612 - Phone
- (608) 822-6100
- NPI assigned
- Feb 8, 2023
- Sex
- Female
- 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 |
|---|---|---|---|
| 3306-19 | WI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 3306-19 | WI | Yes |
| Physical Therapy Assistant | 225200000X | MI |
Addresses
Primary practice location
1850 11TH St
Fennimore, WI 53809-1612
Mailing address
1030 Camp St
Platteville, WI 53818-1506
Phone (608) 642-1151
Other providers in Fennimore, WI
- Fennimore Healing Arts, LLC
- Fennimore SNF Operations, LLC
- Andrew Thomas Fessler
- Stephanie Elin Foster
- Ashlyn Jo Boebel Fritche
- Grant Regional Health Center, Inc
- GTN Fennimore, Inc.
- Jacqueline Hanson
- Hartig Drug Co Corp
- Amanda Lee Haugrud
All providers in Fennimore, WI · Physical Therapy Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 19, 2025. 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.