Doctor Name: | DR. GARY ROSCOE GARDNER |
NPI Number: | 1083620041 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C |
License Number: | 4707 |
Business Practice Address: | 13106 Shelbyville Rd Louisville, KY - 402431572 |
Business Phone Number: | 5022530025 |
Business Fax Number: | 5022539933 |
Mailing Address: | 5213 Windy Willow Dr, LOUISVILLE |
State: | KY |
Postal Code: | 402411360 |
Phone Number: | 5022416730 |
Fax Number: | 5022539933 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 4707 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |