Individual
MR. DAVID ALAN GORDON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
AT
Contact information
Practice address
1500 N OAKLAND AVE, BOLIVAR, MO 65613-3011
(417) 777-7763
(417) 777-4378
Mailing address
3407 S HALL AVE, SPRINGFIELD, MO 65804-4800
(417) 890-1354
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00140
MO
Other
Enumeration date
02/08/2006
Last updated
07/08/2007
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