Individual
JONATHON WESLEY GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, SCS, CSCS
Contact information
Practice address
131 PROVIDENCE RD STE 100, CHARLOTTE, NC 28207-1251
(980) 265-8869
Mailing address
131 PROVIDENCE RD STE 100, CHARLOTTE, NC 28207-1251
(980) 265-8869
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
11288
SC
2251S0007X
Sports Physical Therapist
Primary
P23364
NC
2251X0800X
Orthopedic Physical Therapist
27017
MD
Other
Enumeration date
07/12/2018
Last updated
02/25/2025
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