SearchOhio376J00000X

Bethany Gordon

NPI 1720687833 · on the registry since 2020 · sole proprietor

Practice

Address
2528 Haviland Ct
Mansfield, OH 44903
Phone
(419) 565-6575

Registry record

Primary taxonomy
376J00000X
376J00000X
Also registered as
347C00000X
390200000X
Licence states on file
OH
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2023-10-23

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 Ohio