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Individual

MRS. JUDITH LEFFLER GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
295 CAPRI DR, GAINESVILLE, GA 30506-1752
(770) 536-1633
(770) 536-0197
Mailing address
2475 HAWTHORNE LN, GAINESVILLE, GA 30506-1905
(770) 718-9238

Taxonomy

Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT008231
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1134284276
NPI CORPORATION ID NUMBER
GA
Enumeration date
04/19/2007
Last updated
07/09/2007
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