Individual
MRS. CHRISTINE LARAE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
60 MAGNOLIA ST, CASPER, WY 82604-4035
(307) 234-9381
Mailing address
12105 ZERO RD, CASPER, WY 82604-9541
(307) 277-2534
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA-0537
WY
Other
Enumeration date
03/07/2023
Last updated
03/07/2023
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