Individual
MR. AMANDA MAY GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
309 JACKSON ST, MONROE, LA 71201-7407
(318) 327-4072
(318) 327-4069
Mailing address
126 CRESTVIEW DR, WEST MONROE, LA 71291-7553
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1922
LA
Other
Enumeration date
09/14/2005
Last updated
07/08/2007
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