Individual
MRS. LISA J GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
634 E BROAD ST, BETHLEHEM, PA 18018-6362
(610) 625-4885
Mailing address
5301 PINEVIEW DR, CENTER VALLEY, PA 18034-8801
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP000744L
PA
Other
Enumeration date
06/30/2008
Last updated
06/30/2008
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