Individual
MS. JACQUELINE GALE MCGORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1038 N WALKER AVE, LAKELAND, FL 33805-4276
(863) 688-9776
(863) 688-9776
Mailing address
828 W 2ND ST, LAKELAND, FL 33805-4226
(863) 688-9776
(863) 688-0675
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
6906490
FL
Other
Enumeration date
09/15/2010
Last updated
08/23/2011
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