Organization
CHRISANNE GORDON, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISANNE GORDON MD (PHYSICIAN)
(937) 578-2255
Entity
Organization
Contact information
Practice address
500 LONDON AVENUE, MARYSVILLE, OH 43040
(937) 578-2255
Mailing address
6724 PERIMETER LOOP RD., PMB #317, DUBLIN, OH 43017
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
35042915
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0707328
—
OH
Enumeration date
03/27/2015
Last updated
03/27/2015
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