Individual
MR. MITCHELL MASON GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
233 NEW CANAAN AVE, NORWALK, CT 06850-1416
(203) 846-0421
(203) 849-9022
Mailing address
233 NEW CANAAN AVE, NORWALK, CT 06850-1416
(203) 846-0421
(203) 849-9022
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
000976
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050000976CT02
ANTHEM BLUE CROSS & BLUE
CT
01
—
720384
CTCARE
CT
Enumeration date
05/02/2007
Last updated
07/08/2007
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