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General NPI Number Information
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NPI Number | 1205306461
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Entity Type | Individual
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Provider Name | GAVIN SCOTT HARDEN DPT, PT
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Gender | Male
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Dates
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Enumeration Date | 11/30/2018
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 621 SCIENCE DR
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City | MADISON
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State | WI
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Zip | 53711-1074
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Country | US
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Telephone | 608-265-8303
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Fax |
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Provider Business Mailing Address
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Address Line | 1724 WILLOW ROCK RD APT 202
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City | MADISON
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State | WI
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Zip | 53718-9266
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Country | US
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Telephone | 248-804-2758
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number | 17315-24
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License Number State | WI
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