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1952731184
ANTHONY DESHAWN GORDON
OKLAHOMA CITY, OK
NPI
1952731184
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2013-11-25
Last Update Date
2013-11-25
Business Address
Mr. ANTHONY DESHAWN GORDON
5205 NW 111TH ST
OKLAHOMA CITY, OK 73162-5908
Phone number: 405-822-0079
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Mailing Address
Mr. ANTHONY DESHAWN GORDON
5205 NW 111TH ST
OKLAHOMA CITY, OK 73162-5908
Phone number: 405-822-0079
Copy
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