Individual
KARIANNE J GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, CSCS
Contact information
Practice address
4702 VAHALLA DR, CHAMPAIGN, IL 61822-3334
(217) 621-1847
Mailing address
4702 VAHALLA DR, CHAMPAIGN, IL 61822-3334
(217) 621-1847
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
096.003965
IL
2255A2300X
Athletic Trainer
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Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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