Individual
WILIAM SAMUEL GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
5417 BOXWOOD LN, MARION, MS 39342-9018
(601) 917-6781
Mailing address
5417 BOXWOOD LN, MARION, MS 39342-9018
(601) 917-6781
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT0421
MS
Other
Enumeration date
08/11/2022
Last updated
08/11/2022
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