Individual
RONDINE O GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
5503 MOUNTAIN VIEW PASS, STONE MOUNTAIN, GA 30087-6020
(770) 879-7382
Mailing address
5503 MOUNTAIN VIEW PASS, STONE MOUNTAIN, GA 30087-6020
(770) 879-7382
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
RN172806
GA
Other
Enumeration date
08/09/2012
Last updated
08/09/2012
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