Gardner, Scott Gregory

Gardner, Scott Gregory is an individual health care provider with primary practice located at 4080 W Broadway Ave Suite 300, Robbinsdale MN 55422-5604. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Gardner, Scott Gregory can be contacted via phone (763) 520-0167.

Contact Information

Primary practice address
4080 W Broadway Ave Suite 300 Robbinsdale MN 55422-5604
Phone: (763) 520-0167
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1063577880
LBN Legal business name Gardner, Scott Gregory
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063577880 NPPES
Minnesota Other 1236 A.T. REGISTRATION

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