Individual
LYDIA C. GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 MAIN ST, POINT PLEASANT, WV 25550-1317
(304) 675-4540
Mailing address
1200 MAIN ST, POINT PLEASANT, WV 25550-1317
(304) 675-4540
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
36983
WV
Other
Enumeration date
04/29/2009
Last updated
04/29/2009
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