Individual
MS. LEAETTA MILDRED GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN/ADM
Contact information
Practice address
13450 COUNTY ROAD 7040, ROLLA, MO 65401
(573) 341-8000
(573) 426-3964
Mailing address
13450 COUNTY ROAD 7040, ROLLA, MO 65401
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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