Individual
WILLIAM MARCUS GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
96 WREN WALK, HIRAM, GA 30141-5714
(770) 948-8000
Mailing address
1575 RIDENOUR PKWY NW APT 2131, KENNESAW, GA 30152-4552
(815) 391-1809
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT014097
GA
Other
Enumeration date
02/12/2024
Last updated
02/12/2024
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