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General NPI Number Information
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NPI Number | 1528014073
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Entity Type | Individual
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Provider Name | GORDON C DENDY P.T., M.P.T.
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Gender | Male
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 9085 SANDIDGE CENTER CV
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-3575
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Country | US
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Telephone | 662-890-2663
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Fax |
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Provider Business Mailing Address
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Address Line | 421 E COMMERCE ST
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City | HERNANDO
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State | MS
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Zip | 38632-2348
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Country | US
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Telephone | 662-449-2811
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Fax | 662-449-2812
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT6468
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT3860
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License Number State | MS
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