NPI 1063035616

Tyler Gardiner, ATC

Practitioner Athletic Trainer South Portland, ME

Practice location

Address: 119 Gannett Dr, South Portland, ME 04106-6942
Phone: (207) 773-0040
Mailing address: 61 Green St, Watertown, MA 02472-2351

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence AT881 (ME)

Other Specialist/Technologist providers in Maine →

Registry record

NPI: 1063035616
Entity type: Individual
Sex (as registered): Male
NPI issued: 18 May 2020
Record last updated: 23 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.