Individual
MR. KEVIN BRUCE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1816 SYDENHAM TRAIL, VIRGINIA BEACH, VA 23464-8917
(757) 635-0578
Mailing address
1816 SYDENHAM TRL, VIRGINIA BEACH, VA 23464-8917
(757) 635-0578
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202009072
VA
Other
Enumeration date
08/21/2019
Last updated
08/21/2019
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