Individual
MR. ROBERT GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
444 WOLCOTT RD, WOLCOTT, CT 06716-2639
(203) 879-4695
(203) 879-4696
Mailing address
305 S EAGLE ST, TERRYVILLE, CT 06786-6705
(203) 910-1394
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
002617
CT
Other
Enumeration date
08/11/2020
Last updated
08/11/2020
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