Lance Lee Gardner, PT | |
52 Rising Sun Town Ctr, Rising Sun, MD 21911-1902 | |
(410) 658-0100 | |
Not Available |
Full Name | Lance Lee Gardner |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 23 Years |
Location | 52 Rising Sun Town Ctr, Rising Sun, Maryland |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710088141 | NPI | - | NPPES |
3117934 | Other | PA | US HEALTH CARE |
GA1446210 | Other | PA | BLUE SHIELD |
2129596000 | Other | PA | KEYSTONE |
11227669 | Other | PA | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251X0800X | Physical Therapist - Orthopedic | PT015177 (Pennsylvania) | Secondary |
225100000X | Physical Therapist | 22795 (Maryland) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Ati Holdings Llc | 9537112719 | 366 |
Provider Name | Ati Holdings Llc |
---|---|
Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1396781050 PECOS PAC ID: 9537112719 Enrollment ID: O20060727000214 |
Mailing Address | Practice Location Address |
---|---|
Lance Lee Gardner, PT 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Lance Lee Gardner, PT 52 Rising Sun Town Ctr, Rising Sun, MD 21911-1902 Ph: (410) 658-0100 |
Ati Holding Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 52 Rising Sun Town Ctr, Rising Sun, MD 21911 Phone: 410-658-0100 | |
Courtney Eve Christman, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 52 Rising Sun Town Ctr, Rising Sun, MD 21911 Phone: 410-658-0100 Fax: 410-658-0199 | |
Mr. Antonio Eacdine Pomponi, MPT CERT MDT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 52 Rising Sun Town Ctr, Rising Sun, MD 21911 Phone: 410-658-0100 Fax: 410-658-0199 | |
Thomas Ballenger, MSPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 52 Rising Sun Town Ctr, Rising Sun, MD 21911 Phone: 410-658-0100 Fax: 410-658-0199 | |
Frederick Earl Jenkins Iii, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1881 Telegraph Rd, Rising Sun, MD 21911 Phone: 410-658-6555 | |
Ati Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 52 Rising Sun Town Ctr, Rising Sun, MD 21911 Phone: 410-297-8141 | |
Judith Brown, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 52 Rising Sun Town Ctr, Rising Sun, MD 21911 Phone: 410-658-0100 Fax: 410-658-0199 |