Individual
PAMELA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1116 N GEYER RD, KIRKWOOD, MO 63122-1134
(314) 596-6099
Mailing address
1116 N GEYER RD, KIRKWOOD, MO 63122-1134
(314) 596-6099
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
002798
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3149099698
—
MO
Enumeration date
08/12/2010
Last updated
08/12/2010
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