MICHAEL GORDON

FREEPORT, IL
NPI1275981805
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy172V00000X Community Health Worker
(Licence: IL  ADS1101002)
Enumeration Date2016-05-24
Last Update Date2016-05-24
Business Address
-- MICHAEL GORDON
659 E JEFFERSON ST
FREEPORT, IL 61032-6027
Phone number: 815-229-1999
Mailing Address
-- MICHAEL GORDON
659 E JEFFERSON ST
FREEPORT, IL 61032-6027
Phone number: 815-229-1999
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