Individual
MR. KEITH J GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
113 E COLLEGE BLVD, ROSWELL, NM 88201-5158
(575) 622-6500
(575) 622-9777
Mailing address
113 E COLLEGE BLVD, ROSWELL, NM 88201-5158
(575) 622-6500
(575) 622-9777
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
72
NM
Other
Enumeration date
04/16/2007
Last updated
10/15/2008
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