Individual
MR. JUSTIN W GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
3500 SW 119TH ST, OKLAHOMA CITY, OK 73170-4500
(405) 692-3252
Mailing address
3500 SW 119TH ST, OKLAHOMA CITY, OK 73170-4500
(405) 692-3252
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
731
OK
Other
Enumeration date
05/24/2014
Last updated
05/24/2014
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