Individual
ANDREW GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
340 N MAPLE AVE, PURCELLVILLE, VA 20132-3138
(540) 751-2410
Mailing address
340 N MAPLE AVE, PURCELLVILLE, VA 20132-3138
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126000232
VA
Other
Enumeration date
05/21/2014
Last updated
05/21/2014
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