NPI 1083213235

Ryan Joseph Gardner, RPH

Practitioner Pharmacist New London, WI

Practice location

Address: 1717 N Shawano St, New London, WI 54961-9365
Phone: (920) 982-7906
Fax: (920) 982-7915

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 19428-40 (WI)

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Registry record

NPI: 1083213235
Entity type: Individual
Sex (as registered): Male
NPI issued: 20 Oct 2020
Record last updated: 20 Oct 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.