Stephanie Vicky Gordon, LMT

NPI #1629376835 in Bartlett, Tennessee

Provider Information

NPI Number: 1629376835
Entity Type: Individual
Name: Stephanie Vicky Gordon, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Mar 11, 2011
Last Updated: Mar 11, 2011

Practice Location

Address: 2874 SHELBY ST
Address 2: SUITE 108
City: Bartlett
State: Tennessee
ZIP Code: 38134-4579
Phone: (901) 451-0663

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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