Individual
MR. COLESON RJ GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
880 LAKECREST AVE APT 1C, HIGH POINT, NC 27265-2671
(219) 707-0399
Mailing address
880 LAKECREST AVE APT 1C, HIGH POINT, NC 27265-2671
(219) 707-0399
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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