Michelle L Gordon
Contractor in Edmond, OK. Individual provider (NPI-1).
NPI number1174897524
StatusActive
Last updated in NPPESMar 2, 2012
Details
- NPI
- 1174897524
- Entity type
- Individual (NPI-1)
- Name
- Michelle L Gordon
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 2, 2012
- Last updated
- Mar 2, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 171W00000X | Contractor | – | – | Yes |
Practice location
1409 Craig BlvdEdmond, OK 73003-3135
Phone 405-248-1155
Mailing address
1409 Craig BlvdEdmond, OK 73003-3135
Phone 405-248-1155
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