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Individual

GORDON E NORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
BOC-P, LOA

Contact information

Practice address
1401 W MAGNOLIA AVE, FORT WORTH, TX 76104-4250
(817) 923-2101
Mailing address
1401 W MAGNOLIA AVE, FORT WORTH, TX 76104-4250
(817) 923-2101

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
510
TX
225000000X
Orthotic Fitter
1144
TX

Other

Enumeration date
08/28/2009
Last updated
08/28/2009
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