Individual
GWENDOLYN TANNER GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1415 BARCLAY CIR SE, MARIETTA, GA 30060-2943
(770) 792-6100
(770) 792-6113
Mailing address
1415 BARCLAY CIR SE, MARIETTA, GA 30060-2943
(770) 792-6100
(770) 792-6113
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR009011
GA
111NN1001X
Nutrition Chiropractor
CHIR009011
GA
Other
Enumeration date
11/18/2020
Last updated
04/07/2021
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