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Individual

MARSHALL GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
600 ROBBINS RD, STE 300, BOISE, ID 83702-4565
(208) 489-4016
(208) 489-4015
Mailing address
600 ROBBINS RD, STE 300, BOISE, ID 83702-4565
(208) 489-4016
(208) 489-4015

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA-443
ID

Other

Enumeration date
06/23/2005
Last updated
01/25/2010
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