Individual
MR. BRYCE JAY ALLEN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, MA, CES
Contact information
Practice address
26242 DIMENSION DR STE 150, LAKE FOREST, CA 92630-7811
(831) 332-8838
Mailing address
22 AMATO, MISSION VIEJO, CA 92692-5144
(831) 332-8838
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/02/2019
Last updated
08/26/2021
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