Individual
MS. DOROTHY MIA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
1114 S WALL ST, CALHOUN, GA 30701-3062
(706) 624-3000
(706) 624-3001
Mailing address
365 S INDUSTRIAL BLVD, CALHOUN, GA 30701-3075
(706) 624-3000
(706) 624-3001
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
001642
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00751308F
—
GA
Enumeration date
11/29/2006
Last updated
12/08/2021
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