Kelly A Gardner, DPT | |
307 Riverside Dr, Clayton, NY 13624-1022 | |
(315) 285-5159 | |
Not Available |
Full Name | Kelly A Gardner |
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Gender | Female |
Speciality | Physical Therapist |
Location | 307 Riverside Dr, Clayton, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184620478 | NPI | - | NPPES |
02302812 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 014782 (New York) | Primary |
Provider Name | Northern Physical Therapy Llc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1174624969 PECOS PAC ID: 5092793398 Enrollment ID: O20040713000295 |
Provider Name | South Jefferson Physical Therapy Pc |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1407930829 PECOS PAC ID: 8224205604 Enrollment ID: O20120126000029 |
Mailing Address | Practice Location Address |
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Kelly A Gardner, DPT 70 N Main St, Adams, NY 13605-3102 Ph: (315) 232-2225 | Kelly A Gardner, DPT 307 Riverside Dr, Clayton, NY 13624-1022 Ph: (315) 285-5159 |
Madison Isabella Henning, PT,DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 307 Riverside Dr, Clayton, NY 13624 Phone: 315-686-1757 | |
Alexis Stewart, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 307 Riverside Dr, Clayton, NY 13624 Phone: 315-686-1757 |