Individual
MR. JEROME GORDON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR-L
Contact information
Practice address
787 E NORTHSIDE DR, JACKSON, MS 39206-4945
(504) 813-4968
Mailing address
PO BOX 587, CLINTON, MS 39060-0587
(504) 813-4968
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT1848
MS
Other
Enumeration date
01/24/2007
Last updated
06/16/2019
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