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Individual

KATHLEEN P GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
122 SOUTH MAIN STREET, UNIT D, BRECKENRIDGE, CO 80424
(970) 453-3990
(970) 453-2365
Mailing address
PO BOX 5584, FRISCO, CO 80443-5584

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL0013011
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PTL0013011
STATE OF COLORADO
CO
Enumeration date
09/29/2017
Last updated
11/09/2017
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