Individual
MR. CHARLES ROBERT GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., ATC, C.S.C.S
Contact information
Practice address
3910 TEAYS VALLEY RD, HURRICANE, WV 25526-9756
(304) 757-7293
(304) 757-0574
Mailing address
RR 2 BOX 223-1, RED HOUSE, WV 25168-9663
(304) 550-3499
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
WV
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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