Individual
VICKI L GORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1380 S COLUMBIA RD, GRAND FORKS, ND 58201-4059
(701) 795-2000
Mailing address
2401 DEMERS AVE, GRAND FORKS, ND 58201
(701) 780-1891
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAC0156
ND
Other
Enumeration date
09/27/2006
Last updated
10/19/2020
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