Individual
MRS. KELLY CREWS GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
53 ADDIE WAY, LYNCHBURG, VA 24501-7255
(434) 444-0637
Mailing address
53 ADDIE WAY, LYNCHBURG, VA 24501-7255
(434) 444-0637
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306001824
VA
Other
Enumeration date
04/30/2015
Last updated
04/30/2015
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