Individual
KELLY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
13207 RAVENNA RD, CHARDON, OH 44024-7032
(330) 656-9304
(330) 656-5901
Mailing address
5700 DARROW RD, SUITE 106, HUDSON, OH 44236-5026
(330) 656-9304
(330) 656-5901
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
OH
Other
Enumeration date
01/16/2013
Last updated
11/17/2015
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