Individual
COURTNEY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
15885 GODDARD RD, APT 206, SOUTHGATE, MI 48195-4469
(801) 425-0459
Mailing address
15885 GODDARD RD, APT 206, SOUTHGATE, MI 48195-4469
(801) 425-0459
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502004947
MI
Other
Enumeration date
08/15/2016
Last updated
08/15/2016
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