Individual
MR. DERRICK GORDON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 FLETCHER AVE NE, CANTON, OH 44705-4625
(330) 268-6592
Mailing address
2401 FLETCHER AVE NE, CANTON, OH 44705-4625
(330) 268-6592
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
TH945069
OH
Other
Enumeration date
03/25/2024
Last updated
03/25/2024
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