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1588892954
RICKY LANE GARDNER
TREMONTON, UT
NPI
1588892954
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: UT 9009537-1205)
Enumeration Date
2009-06-24
Last Update Date
2021-09-29
Business Address
RICKY LANE GARDNER MD
935 N 1000 W
TREMONTON, UT 84337-9356
Phone number: 435-207-4800
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Mailing Address
RICKY LANE GARDNER MD
PO BOX 27128
SALT LAKE CITY, UT 84127-0128
Phone number:
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