Individual
MR. JERRY LEE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
1651 KENDALL ST, LAKEWOOD, CO 80214-1412
(303) 232-4002
(303) 232-4392
Mailing address
4851 INDEPENDENCE ST, SUITE 200, WHEAT RIDGE, CO 80033-6715
(303) 425-0300
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
41892
CO
Other
Enumeration date
04/12/2007
Last updated
07/08/2007
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