Individual
DEANNA MARIE GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
124 GROVE ST, JOHNSONBURG, PA 15845-1427
(814) 965-2328
Mailing address
124 GROVE ST, JOHNSONBURG, PA 15845-1427
(814) 965-2328
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006551-1
NY
Other
Enumeration date
05/18/2007
Last updated
07/08/2007
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