Shirley L Gordon
Technician/Technologist, Optician in Hamilton, MT. Individual provider (NPI-1).
NPI number1467605352
StatusActive
Last updated in NPPESOct 23, 2008
Details
- NPI
- 1467605352
- Entity type
- Individual (NPI-1)
- Name
- Shirley L Gordon
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 23, 2008
- Last updated
- Oct 23, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1800X | Technician/Technologist, Optician | – | – | Yes |
Practice location
120 S 5th StSte 104
Hamilton, MT 59840-1200
Phone 406-541-3918 · Fax 406-541-3813
Mailing address
Po Box 4907Missoula, MT 59806
Phone 406-541-3918 · Fax 406-541-3813
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