Individual
DR. MICHAEL W GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
214 N. BDWY, SPRING VALLEY, MN 55975
(507) 346-7555
(507) 346-7555
Mailing address
214 N. BDWY, SPRING VALLEY, MN 55975
(507) 346-7555
(507) 346-7555
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1979000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318262200
—
MN
Enumeration date
01/24/2006
Last updated
08/29/2008
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