Individual
CHARLIE RENEE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BHRS
Contact information
Practice address
112 N HIGH ST, ANTLERS, OK 74523-2250
(580) 298-3001
Mailing address
814 N HIGHLAND ST, SEMINOLE, OK 74868-3270
(405) 303-2735
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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