Individual
LOWELL LYNN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S EAGLE RD, SUITE 1241, MERIDIAN, ID 83642-6351
(208) 288-2255
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-2222
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4765
ID
Other
Enumeration date
07/07/2006
Last updated
03/14/2011
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