Individual
MR. GORDON WONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1441 N 12TH ST FL 3, PHOENIX, AZ 85006-2837
(602) 521-5977
(602) 521-5904
Mailing address
1441 NORTH 12TH STREET 3RD FLOOR, PHOENIX, AZ 85006
(602) 521-5977
(602) 521-5904
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/09/2017
Last updated
07/21/2022
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