Individual
MRS. KIMBERLY ROCHELLE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SURGICAL ASSISTANT
Contact information
Practice address
3002 GILL ST STE 3, BLOOMINGTON, IL 61704-3438
(309) 846-4716
Mailing address
1213 RIVIERA DR, BLOOMINGTON, IL 61701-7309
(309) 242-6439
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
—
—
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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