Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 2833-19 | WI |
NPI | 1013498732 |
---|---|
Provider Name | Lindsay Gardenier |
First Address | Glenview, IL 60026-8001 |
Second Address | Milwaukee, WI 53223-1074 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2018 |
Last Update Date | 22/08/2018 |