Individual
JANNA LEA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
252 WEST 5TH STREET, LA CENTER, KY 42056
(270) 665-5875
Mailing address
556 BORDEN RD, WICKLIFFE, KY 42087-9261
(270) 334-3738
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A01141
KY
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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