Individual
MRS. MEGAN TUCKER GORDON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
8 ZACHARY PL, AUGUSTA, GA 30907-3273
(706) 951-5573
Mailing address
8 ZACHARY PL, AUGUSTA, GA 30907-3273
(706) 951-5573
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
2958
SC
225X00000X
Occupational Therapist
Primary
OT004032
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH1602
—
SC
Enumeration date
05/05/2006
Last updated
07/09/2007
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