| Doctor Name: | TIMOTHY R GORDON |
| NPI Number: | 1548338163 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MSPT |
| License Number: | 1816 |
| Business Practice Address: | 760 Hospital Circle Browning, MT - 594170760 |
| Business Phone Number: | 4063386129 |
| Business Fax Number: | 4063383202 |
| Mailing Address: | Po Box 760, BROWNING |
| State: | MT |
| Postal Code: | 594170760 |
| Phone Number: | 4063386129 |
| Fax Number: | 4063383202 |
| NPI Enumeration Date: | 12/01/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 1816 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |