Gordon, Jennifer

Gordon, Jennifer is an individual health care provider with primary practice located at 14999 Health Center Dr Ste 201 , Bowie MD 20716-1087. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Gordon, Jennifer can be contacted via phone (240) 245-4245.

Contact Information

Primary practice address
14999 Health Center Dr Ste 201 Bowie MD 20716-1087
Phone: (240) 245-4245
Fax: (240) 245-4916
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 21047 Maryland

Profile Details

NPI number 1487615027
LBN Legal business name Gordon, Jennifer
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Oct 1st, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487615027 NPPES
Maryland MEDICAID 336407100

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