Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT 3581 | AR |
N | 2251S0007X | Physical Therapist - Sports | PT3581 | AR |
N | 2251X0800X | Physical Therapist - Orthopedic | PT3581 | AR |
NPI | 1447690201 |
---|---|
Provider Name | Richard Louis Gardner |
First Address | Rogers, AR 72758-7341 |
Second Address | Rogers, AR 72758-7341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2013 |
Last Update Date | 06/02/2020 |