Individual
MR. GORDON THOMAS IRELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LLBSW
Contact information
Practice address
22800 HALL RD, CLINTON TOWNSHIP, MI 48036-4804
(586) 477-2054
(586) 477-2056
Mailing address
585 JEWETT RD, MASON, MI 48854-8729
(517) 676-5405
(517) 676-5460
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
6802086949
MI
Other
Enumeration date
06/28/2012
Last updated
06/28/2012
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