Doctor Name: | SHELLY P GARDNER |
NPI Number: | 1679617435 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | PT1594 |
Business Practice Address: | 1080 Neal St Suite 300 Cookeville, TN - 38501 |
Business Phone Number: | 9313722567 |
Business Fax Number: | 9313722572 |
Mailing Address: | 1080 Neal St, Suite 300 COOKEVILLE |
State: | TN |
Postal Code: | 38501 |
Phone Number: | 9313722567 |
Fax Number: | 9313722572 |
NPI Enumeration Date: | 02/16/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT1594 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |