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Individual
MR. FREDERICK GARDNER
Active
Individual
MR. FREDERICK GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009506-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO95069
WORKERS' COMPENSATION
NY
Enumeration date
06/12/2006
Last updated
02/09/2012
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