Individual
KRISTIN LEA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5028 BILLY K TRL, MYRTLE BEACH, SC 29579-4120
(843) 457-9427
Mailing address
5028 BILLY K TRL, MYRTLE BEACH, SC 29579-4120
(843) 457-9427
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2327
SC
Other
Enumeration date
07/21/2026
Last updated
07/21/2026
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