Alyssa Marie Gardner, | |
2776 Janitell Rd, Colorado Springs, CO 80906-4103 | |
(719) 332-4689 | |
Not Available |
Full Name | Alyssa Marie Gardner |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 2776 Janitell Rd, Colorado Springs, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528777521 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | OT.0007657 (Colorado) | Primary |
Provider Name | Katey Blehm M.a. Ccc-slp |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1457962417 PECOS PAC ID: 3476866880 Enrollment ID: O20160505000820 |
Mailing Address | Practice Location Address |
---|---|
Alyssa Marie Gardner, 1180 Medley Grv Apt 304, Colorado Springs, CO 80921-4526 Ph: (810) 305-2830 | Alyssa Marie Gardner, 2776 Janitell Rd, Colorado Springs, CO 80906-4103 Ph: (719) 332-4689 |
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