Individual
MR. TIMOTHY WARREN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
630 S RANCHO DR, SUITE A, LAS VEGAS, NV 89106-4873
(702) 636-4047
Mailing address
3221 INDIAN MOON DR, LAS VEGAS, NV 89129-7329
(702) 636-4047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
559
NV
Other
Enumeration date
09/06/2006
Last updated
07/08/2007
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