Individual
MR. M THOMAS GORDY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSI, LMT
Contact information
Practice address
6135 LAKESIDE DR, SUITE 119, RENO, NV 89511-8504
(775) 220-2482
Mailing address
1420 FOSTER DR, RENO, NV 89509-1208
(775) 220-2482
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
003
NV
Other
Enumeration date
10/26/2009
Last updated
10/26/2009
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