Individual
MS. CAROL ANNE GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12510 VAN NUYS BLVD. #200, PACOIMA, CA 91331
(626) 831-5079
Mailing address
12510 VAN NUYS BLVD. #200, PACOIMA, CA 91331
(626) 831-5079
Taxonomy
Speciality
Code
Description
License number
State
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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