Individual
KENNETH GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2005 12TH AVE RD, NAMPA, ID 83686-6311
(208) 463-0022
(208) 463-0031
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(951) 374-7288
(951) 666-5099
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
8980
ID
Other
Enumeration date
04/22/2019
Last updated
12/21/2023
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