Individual
MR. KELON GARDNER SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
535 DAFFODIL ST, MOUNT AIRY, LA 70076-2011
(985) 248-2019
Mailing address
535 DAFFODIL ST, MOUNT AIRY, LA 70076-2011
(985) 248-2019
Taxonomy
Speciality
Code
Description
License number
State
347E00000X
Transportation Broker
Primary
007543185
LA
Other
Enumeration date
05/18/2022
Last updated
05/18/2022
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