Provider Demographics
NPI:1972737757
Name:GARDNER, ABBY MARIE (CMT, HHP)
Entity Type:Individual
Prefix:MRS
First Name:ABBY
Middle Name:MARIE
Last Name:GARDNER
Suffix:
Gender:F
Credentials:CMT, HHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 N SHELDON RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1033
Mailing Address - Country:US
Mailing Address - Phone:734-927-4805
Mailing Address - Fax:
Practice Address - Street 1:33211 GRAND RIVER AVE STE B
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:MI
Practice Address - Zip Code:48336-6403
Practice Address - Country:US
Practice Address - Phone:248-477-1492
Practice Address - Fax:248-477-1052
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist