Individual
FAITH GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1026 HEART PINE DR, BLYTHEWOOD, SC 29016-7321
(803) 546-8824
Mailing address
1026 HEART PINE DR, BLYTHEWOOD, SC 29016-7321
(803) 546-8824
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
51310731
GA
Other
Enumeration date
10/26/2021
Last updated
10/26/2021
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