Individual
GEORGE GLENN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
102 E. MAIN ST, ADRIAN, MO 64720-9207
(816) 297-2640
Mailing address
PO BOX 370, BUTLER, MO 64730-0370
(660) 200-7033
(660) 200-7015
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1706
TN
363A00000X
Physician Assistant
Primary
2011020458
MO
Other
Enumeration date
03/17/2009
Last updated
08/01/2011
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