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1184267346
CHANEL GORDON
MESA, AZ
NPI
1184267346
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1744P3200X Specialist, Prosthetics Case Management
Enumeration Date
2019-10-21
Last Update Date
2019-10-21
Business Address
CHANEL GORDON
1731 W BASELINE RD STE 107
MESA, AZ 85202-5730
Phone number: 480-687-2336
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Mailing Address
CHANEL GORDON
1731 W BASELINE RD STE 107
MESA, AZ 85202-5730
Phone number: 513-828-5597
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