Individual
AUSTIN BLAKE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 TERRY AVE, SPRINGDALE, AR 72764-7025
(479) 249-5273
Mailing address
200 TERRY AVE, SPRINGDALE, AR 72764-7025
(479) 249-5273
Taxonomy
Speciality
Code
Description
License number
State
251V00000X
Voluntary or Charitable Agency
Primary
—
—
Other
Enumeration date
05/28/2025
Last updated
05/28/2025
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