Individual
MR. SHANNON L GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
2601 JESS NEELY DR, NASHVILLE, TN 37212
(615) 322-8769
Mailing address
2601 JESS NEELY DR, NASHVILLE, TN 37212
(615) 322-8769
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 000195
TN
2255A2300X
Athletic Trainer
AT-1680
OH
Other
Enumeration date
02/07/2006
Last updated
07/08/2007
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