Individual
GORDON SANDERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2954 WALNUT STREET, PORTSMOUTH, OH 45662
(740) 353-1111
Mailing address
2954 WALNUT STREET, PORTSMOUTH, OH 45662
(740) 353-1111
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
150278
OH
Other
Enumeration date
04/12/2016
Last updated
04/12/2016
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