Individual
ANDREW TAIT GORDINIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
Mailing address
145 S VIRGINIA ST, CRYSTAL LAKE, IL 60014-7226
(815) 444-9999
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/13/2021
Last updated
07/13/2021
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