Individual
MR. GORDON M POINTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
627 EAST 2ND ST, KEWANEE, IL 61443
(309) 852-6514
(309) 856-5705
Mailing address
627 EAST 2ND ST, KEWANEE, IL 61443
(309) 852-6514
(309) 856-5705
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038007262
IL
111N00000X
Chiropractor
A5729
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038007262
—
IL
Enumeration date
09/27/2006
Last updated
09/26/2011
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