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Jessica Gordon

NPI 1518359736 · on the registry since 2015 · sole proprietor

Practice

Address
4703 Highwood Dr
Fort Wayne, IN 46815
Phone
(260) 797-3604

Registry record

Primary taxonomy
347C00000X
347C00000X
Licence states on file
IN
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2015-02-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Indiana