NPI 1336364124

Keith J Gardner, ATC

Practitioner Athletic Trainer Roswell, NM

Practice location

Address: 113 E College Blvd, Roswell, NM 88201-5158
Phone: (575) 622-6500
Fax: (575) 622-9777

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 72 (NM)

Other Specialist/Technologist providers in New Mexico →

Registry record

NPI: 1336364124
Entity type: Individual
Sex (as registered): Male
NPI issued: 16 Apr 2007
Record last updated: 15 Oct 2008

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.