Provider Demographics
NPI:1306389770
Name:GABLER, CONRAD MATTHEW (PHD, ATC)
Entity Type:Individual
Prefix:DR
First Name:CONRAD
Middle Name:MATTHEW
Last Name:GABLER
Suffix:
Gender:M
Credentials:PHD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1435 VILLAGE DR
Mailing Address - Street 2:SWENSON BLDG, 302J
Mailing Address - City:OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84408-2805
Mailing Address - Country:US
Mailing Address - Phone:801-626-8831
Mailing Address - Fax:801-626-6228
Practice Address - Street 1:1435 VILLAGE DR
Practice Address - Street 2:SWENSON BLDG, 302J
Practice Address - City:OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84408-2805
Practice Address - Country:US
Practice Address - Phone:801-626-8831
Practice Address - Fax:801-626-6228
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9881218-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer