Individual
LISA MARIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUDIOLOGIST MS.CCC.A
Contact information
Practice address
1601 NW 114TH ST, SUITE 230, CLIVE, IA 50325-7007
(515) 222-7761
(515) 222-7926
Mailing address
PO BOX 1475, DES MOINES, IA 50305-1475
(515) 643-4374
(515) 643-2784
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
00444
IA
Other
Enumeration date
03/27/2008
Last updated
03/27/2008
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