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Individual

MICHELE MARY GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
660 GOLDEN RIDGE RD STE 130, GOLDEN, CO 80401-9541
(303) 275-2190
Mailing address
660 GOLDEN RIDGE RD STE 130, GOLDEN, CO 80401-9541
(303) 275-2190

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
1075776
OR
225X00000X
Occupational Therapist
6729
NC
225XH1200X
Hand Occupational Therapist
Primary
6222
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
346512
MEDICARE PTAN
NC
Enumeration date
04/19/2006
Last updated
03/09/2020
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