Individual
MRS. LAVONNE ELAINE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 ALDABA CIRCLE NE, RIO RANCHO, NM 87124-0837
(780) 466-9757
Mailing address
209 ALDABA CIRCLE NE, RIO RANCHO, NM 87124-0837
(780) 466-9757
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
10/04/2019
Last updated
10/04/2019
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