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General NPI Number Information
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NPI Number | 1477527141
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Entity Type | Individual
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Provider Name | KEVIN E GARD DPT, OCS
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Gender | Male
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Dates
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Enumeration Date | 02/17/2006
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 1601 CHERRY ST MS 21041
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1320
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Country | US
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Telephone | 215-553-7012
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Fax | 215-553-7019
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Provider Business Mailing Address
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Address Line | 1601 CHERRY ST MS 21041
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City | PHILADELPHIA
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State | PA
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Zip | 19102-1320
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Country | US
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Telephone | 215-553-7012
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Fax | 215-553-7019
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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 | PT007722L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT007722L
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License Number State | PA
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