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Individual

BRIAN KOWALLIS GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
210 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-6163
(435) 722-9291
Mailing address
210 W 300 N, ROOSEVELT, UT 84066-2336
(435) 722-6163
(435) 722-9291

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
6297901-0501
UT

Other

Enumeration date
07/05/2007
Last updated
05/11/2017
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