Individual
MRS. JENNIFER GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
14999 HEALTH CENTER DR STE 201, BOWIE, MD 20716-1087
(240) 245-4245
(240) 245-4916
Mailing address
7500 HANOVER PKWY STE 103, GREENBELT, MD 20770-2011
(301) 446-1644
(301) 446-1647
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
21047
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
336407100
—
MD
Enumeration date
03/31/2006
Last updated
10/01/2013
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