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1912545393
KANISHIA GORDON
ATLANTA, GA
NPI
1912545393
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
224P00000X Prosthetist
Enumeration Date
2019-12-16
Last Update Date
2019-12-16
Business Address
KANISHIA GORDON hair repl specialist
519 MEMORIAL DR SE STE 209
ATLANTA, GA 30312-2286
Phone number: 404-836-3845
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Mailing Address
KANISHIA GORDON hair repl specialist
2025 CLEARSTREAM OVERLOOK
STONE MOUNTAIN, GA 30088-4438
Phone number: 203-565-5872
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