Individual
MARA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2101 COLLIER CORP PARKWAY, ST. CHARLES, MO 63303
(636) 441-4944
Mailing address
609 OREGON TRAIL DR, SAINT CHARLES, MO 63304-7983
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01549
MO
Other
Enumeration date
07/19/2006
Last updated
07/09/2007
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