Individual
KALA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10004 204TH AVE E, STE 3100, BONNEY LAKE, WA 98391-6539
(253) 863-7510
(253) 863-5970
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(630) 296-2223
(630) 759-9510
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
OC014346
PA
225X00000X
Occupational Therapist
Primary
OT60699125
WA
Other
Enumeration date
03/15/2016
Last updated
12/14/2016
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