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Contact Information

KRISTOPHER GORDON
615 E PORTLAND STREET
PHOENIX, AZ85004
 Phone: 602-320-9109
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for KRISTOPHER GORDON · (Male)

NPI # 1952734170
Status Active
Credentials
Entity Individual
Enumeration date 08/12/2013
Last updated 08/12/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • AZ License # 9022A
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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