Individual
DESTINEE MARKIA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
525 SEVILLE RD, GREENVILLE, NC 27834-4890
(252) 814-3089
Mailing address
PO BOX 332, ROBERSONVILLE, NC 27871-0332
(252) 902-4606
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
06/02/2019
Last updated
06/02/2019
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