Individual
BRANDON GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2401 CABEZON BLVD SE STE 102, RIO RANCHO, NM 87124-1513
(505) 994-2599
Mailing address
2401 CABEZON BLVD SE STE 102, RIO RANCHO, NM 87124-1513
(505) 994-2599
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-1326
NM
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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