Individual
MR. DANIEL JUNIOR GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
104 DAVID DR, LEXINGTON, SC 29073-8668
(803) 740-9559
Mailing address
104 DAVID DR, LEXINGTON, SC 29073-8668
(803) 740-9559
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PR40680
SC
Other
Enumeration date
03/18/2010
Last updated
03/18/2010
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