Individual
MR. FREDERICK GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
8402 OSWEGO RD, LIVERPOOL, NY 13090-1004
(315) 622-0102
(315) 622-0112
Mailing address
8402 OSWEGO RD, LIVERPOOL, NY 13090-1004
(315) 622-0102
(315) 622-0112
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X009506-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO95069
WORKERS' COMPENSATION
NY
Enumeration date
06/12/2006
Last updated
02/09/2012
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