Doctor Name: | MS. SHANAE L GORDON |
NPI Number: | 1053689075 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 6464 |
Business Practice Address: | 270 Gayle Ave Nw Aiken, SC - 298014040 |
Business Phone Number: | 8036421974 |
Business Fax Number: | |
Mailing Address: | 2935 Colonial Dr, COLUMBIA |
State: | SC |
Postal Code: | 292036811 |
Phone Number: | 8034011354 |
Fax Number: | |
NPI Enumeration Date: | 12/05/2011 |
NPI Last Update Date: | 12/05/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 6464 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |