MR. Jonathan Todd Gardner, CHES, PTA, EXP

NPI #1962511840 in Springfield, Michigan

Provider Information

NPI Number: 1962511840
Entity Type: Individual
Name: MR. Jonathan Todd Gardner, CHES, PTA, EXP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: CHES, PTA, EXP
Enumeration Date: Aug 30, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2775 W DICKMAN RD
Address 2: SUITE L
City: Springfield
State: Michigan
ZIP Code: 49015-4895
Phone: (269) 966-1101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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