Individual
RICHARD KEVIN GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
44610 MONTEREY AVE, PALM DESERT, CA 92260-3326
(760) 776-7720
Mailing address
1932 W ACACIA AVE, #23, HEMET, CA 92545-3786
(951) 760-0504
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT2236
CA
Other
Enumeration date
09/10/2008
Last updated
09/10/2008
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