TRACEY GORDON

FORT WAYNE, IN
NPI1801144464
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06004303A)
Enumeration Date2012-08-29
Last Update Date2012-08-29
Business Address
-- TRACEY GORDON
2827 NORTHGATE BOULEVARD
FORT WAYNE, IN 46835
Phone number: 260-492-1498
Mailing Address
-- TRACEY GORDON
2827 NORTHGATE BOULEVARD
FORT WAYNE, IN 46835
Phone number: