Individual
SUSAN LEIGH GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
530 HIGHLAND AVE, FEASTERVILLE TREVOSE, PA 19053-6026
(215) 355-0623
Mailing address
530 HIGHLAND AVE, FEASTERVILLE TREVOSE, PA 19053-6026
(215) 355-0623
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT005518L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019326700002
MA
PA
Enumeration date
09/21/2007
Last updated
09/21/2007
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