Individual
EMILY GRACE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
43909 30TH ST W, LANCASTER, CA 93534-5843
(760) 617-0063
Mailing address
43909 30TH ST W, LANCASTER, CA 93534-5843
Taxonomy
Speciality
Code
Description
License number
State
225500000X
Respiratory/Developmental/Rehabilitative Specialist/Technologist
Primary
F5102623
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F5102623
CA
CA
Enumeration date
10/30/2018
Last updated
10/30/2018
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