Individual
KIRA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3007 HARBOR LN N STE 1200, PLYMOUTH, MN 55447-5103
(612) 439-4650
Mailing address
3327 93RD CURV NE, BLAINE, MN 55449-6868
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/07/2021
Last updated
03/07/2021
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