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Individual
DR. KEVIN GORDER
Active
Individual
DR. KEVIN GORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P16840
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P16840
PT LICENSE
NC
Enumeration date
10/14/2022
Last updated
10/14/2022
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