Provider Demographics
NPI:1326482704
Name:GORDON, WILLIAM F (PT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:F
Last Name:GORDON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 MAIN ST STE 201
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-2427
Mailing Address - Country:US
Mailing Address - Phone:978-315-2500
Mailing Address - Fax:978-315-2501
Practice Address - Street 1:70 MAIN ST STE 201
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-2427
Practice Address - Country:US
Practice Address - Phone:978-315-2500
Practice Address - Fax:978-315-2501
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA15496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist