Provider Demographics
NPI:1194903500
Name:GORDON, ERIC R (CERTIFIED ROLFER)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:R
Last Name:GORDON
Suffix:
Gender:M
Credentials:CERTIFIED ROLFER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8750 ALLISON DR
Mailing Address - Street 2:UNIT E
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80005-4818
Mailing Address - Country:US
Mailing Address - Phone:303-653-8107
Mailing Address - Fax:
Practice Address - Street 1:8791 WOLFF CT
Practice Address - Street 2:SUITE 210
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-3600
Practice Address - Country:US
Practice Address - Phone:303-653-8107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist