Individual
JAIME GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16807 E PALISADES BLVD STE 101, FOUNTAIN HILLS, AZ 85268-8438
(480) 765-2677
Mailing address
16457 E BAINBRIDGE AVE, FOUNTAIN HILLS, AZ 85268-2721
(602) 725-4854
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
4454
AZ
Other
Enumeration date
03/26/2014
Last updated
03/05/2019
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