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Individual

JASON L GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
W 4824 MCMAHON BLVD NW, SUITE 101, ALBUQUERQUE, NM 87114
(505) 897-3537
(505) 897-3726
Mailing address
4445 DESERT LILY CT SE, RIO RANCHO, NM 87124-1562
(505) 385-5080

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3379
NM

Other

Enumeration date
02/21/2008
Last updated
02/21/2008
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