Individual
MYRTLE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 S LOGAN ST, 400 SOUTH LOGAN ST., GAFFNEY, SC 29341-1609
(864) 487-2701
Mailing address
PO BOX 87, GAFFNEY, SC 29342-0087
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
17075
SC
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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