Individual
TIMOTHY MICHAEL GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EMT- PARAMEDIC
Contact information
Practice address
10233 W GREENFIELD AVE, MILWAUKEE, WI 53214-3911
(414) 727-5750
Mailing address
1497 RIVERS EDGE PKWY, OCONOMOWOC, WI 53066-6908
(262) 490-4854
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
Primary
41348
WI
Other
Enumeration date
09/28/2021
Last updated
09/28/2021
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