Provider Demographics
NPI:1295407476
Name:GARDNER, SAVANNAH (DC)
Entity Type:Individual
Prefix:DR
First Name:SAVANNAH
Middle Name:
Last Name:GARDNER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 CHAMPIONS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28387-2979
Mailing Address - Country:US
Mailing Address - Phone:910-704-4820
Mailing Address - Fax:
Practice Address - Street 1:262 PINEHURST AVE
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-6351
Practice Address - Country:US
Practice Address - Phone:910-704-4820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010639111N00000X
NC5589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor