Gordon, Jeremy Michael

Gordon, Jeremy Michael is an individual health care provider with primary practice located at 905 N Stone St , Deland FL 32720-2521. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Gordon, Jeremy Michael can be contacted via phone (386) 734-9995.

Contact Information

Primary practice address
905 N Stone St Deland FL 32720-2521
Phone: (386) 734-9995
Fax: (386) 734-9949
Website:
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Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CH7770 Florida

Profile Details

NPI number 1144217480
LBN Legal business name Gordon, Jeremy Michael
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2005
Last updated Oct 8th, 2012 - about 12 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 1144217480 NPPES
Florida MEDICAID 381193000

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