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General NPI Number Information
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NPI Number | 1013426998
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Entity Type | Individual
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Provider Name | NICHOLAS ALEXANDER GARDNER DC
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Gender | Male
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Dates
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Enumeration Date | 09/24/2017
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 290 DANIEL WEBSTER HWY UNIT 2A
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City | MEREDITH
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State | NH
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Zip | 03253-5806
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Country | US
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Telephone | 603-630-3594
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Fax | 603-250-2938
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Provider Business Mailing Address
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Address Line | 1101 NEW WORLD CIR APT 205
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City | RALEIGH
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State | NC
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Zip | 27615-8525
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Country | US
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Telephone | 973-903-7765
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5528
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1023
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License Number State | NH
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