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Individual

MR. JOHN-REID GORDON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
2210 MAIN ST, NUMBER 135, LONGMONT, CO 80501-1456
(720) 204-1746
Mailing address
PO BOX 58, LYONS, CO 80540-0058
(303) 775-3082

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
12730
CO

Other

Enumeration date
09/19/2012
Last updated
09/19/2012
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