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Individual

DR. DUSTIN GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
609 E MAIN ST, JENKS, OK 74037-4138
(918) 299-1296
Mailing address
11515 W 91ST ST S, SAPULPA, OK 74066-8422
(918) 691-6885

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4515
OK

Other

Enumeration date
12/07/2022
Last updated
12/07/2022
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