Individual
TAMIKA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CERTIFIED HAIR LOSS
Contact information
Practice address
33 BERNHARD RD, NORTH HAVEN, CT 06473-3900
(203) 779-6466
Mailing address
2616 STATE ST, HAMDEN, CT 06517-3006
(203) 737-0779
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
Primary
052003
CT
Other
Enumeration date
05/01/2017
Last updated
05/01/2017
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