Individual
LUCAS RAY GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
511 GRIFFIN RD, WEST BRANCH, MI 48661-9251
(989) 345-5540
Mailing address
511 GRIFFIN RD, WEST BRANCH, MI 48661-9251
(989) 345-5540
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
08/23/2022
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