Individual
SAMUEL GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9346 OAK AVE, WACONIA, MN 55387-9422
(952) 442-5812
Mailing address
307 E 7TH ST APT 205, MONTICELLO, MN 55362-8049
(919) 939-6303
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
MN
Other
Enumeration date
03/21/2024
Last updated
06/09/2025
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