Individual
MR. JONATHAN TODD GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHES, PTA, EXP
Contact information
Practice address
2775 W DICKMAN RD, SUITE L, SPRINGFIELD, MI 49015-4895
(269) 966-1101
(269) 966-1113
Mailing address
1621 ROSELAND AVE, KALAMAZOO, MI 49001-4353
(269) 966-1101
(269) 966-1113
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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