Individual
MR. EDWARD GORDON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2472 CHATEAU LN, TALLAHASSEE, FL 32311-5604
(850) 896-4709
Mailing address
115 S PINETREE BLVD APT 1205, BLDG 12, THOMASVILLE, GA 31792-7175
(229) 221-5073
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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