Individual
DR. GORDON KEITH HARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH D
Contact information
Practice address
8036 MOORSBRIDGE ROAD, SUITE 2, PORTAGE, MI 49024-4417
(269) 327-1438
(269) 327-6454
Mailing address
PO BOX 2585, PORTAGE, MI 49081-2585
(269) 381-0150
(269) 373-4720
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
6301005456
MI
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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