Individual
JAIME RENEE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
205 W CRAWFORD ST, VAN WERT, OH 45891-1903
(418) 238-1761
(418) 238-5055
Mailing address
1001 ROSEMONT DR, VAN WERT, OH 45891-2639
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
06004856A
IN
225200000X
Physical Therapy Assistant
Primary
08646
OH
Other
Enumeration date
10/24/2014
Last updated
10/24/2014
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