Individual
JOHN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PHA-PHA-LIC-54918
MT
1835P2201X
Ambulatory Care Pharmacist
Primary
10471829-1721
UT
Other
Enumeration date
07/20/2018
Last updated
08/03/2020
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