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General NPI Number Information
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NPI Number | 1164996062
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Entity Type | Individual
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Provider Name | BARBARA NICOLE GARDNER PT DPT
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Gender | Female
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Dates
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Enumeration Date | 01/14/2019
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Last Update Date | 08/14/2024
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Provider Practice Location Address
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Address Line | 450 W PALMDALE BLVD
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City | PALMDALE
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State | CA
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Zip | 93551-3104
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Country | US
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Telephone | 661-273-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 15439 DAYBREAK LN
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City | FONTANA
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State | CA
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Zip | 92337-0946
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Country | US
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Telephone | 951-256-7568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT297104
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License Number State | CA
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