Individual
DR. MICHELLE ANN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
808 WACKER DR, DUBUQUE, IA 52002
(563) 557-1133
(563) 557-3022
Mailing address
808 WACKER DR, DUBUQUE, IA 52002
(563) 557-1133
(563) 557-3022
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02281
IA
152W00000X
Optometrist
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0425991
—
IA
01
—
36582
BLUE CROSS BLUE SHIELD
—
01
—
819247
EYEMED
—
Enumeration date
05/10/2007
Last updated
07/08/2007
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