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Individual

MRS. MARY KATHLEEN GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
1051 W SOUTH ST, KEWANEE, IL 61443-8354
(309) 852-7931
Mailing address
PO BOX 747, KEWANEE, IL 61443-0747
(309) 852-7931

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056009143
IL

Other

Enumeration date
09/13/2010
Last updated
09/13/2010
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