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1063589612
LEE S GARDNER
IDAHO FALLS, ID
NPI
1063589612
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: ID PA-359)
Enumeration Date
2006-11-29
Last Update Date
2009-12-07
Business Address
-- LEE S GARDNER P.A.-C
2725 CHANNING WAY
IDAHO FALLS, ID 83404-7510
Phone number: 208-525-8448
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Mailing Address
-- LEE S GARDNER P.A.-C
2725 CHANNING WAY
IDAHO FALLS, ID 83404-7510
Phone number: 208-525-8448
Copy
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