Individual
KATIE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5851 W MOORESTOWN RD, MANTON, MI 49663-9012
(586) 295-5615
Mailing address
5851 W MOORESTOWN RD, MANTON, MI 49663
(586) 295-5615
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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