Individual
CHAVIS GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3505 N ELIZABETH ST, DENVER, CO 80205-4245
(804) 901-0179
Mailing address
3505 N ELIZABETH ST, DENVER, CO 80205-4245
(804) 901-0179
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
04/11/2017
Last updated
04/11/2017
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