Individual
KATHY GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3705 TOWER AVE, SUPERIOR, WI 54880-5338
(715) 392-9520
Mailing address
3705 TOWER AVE, SUPERIOR, WI 54880-5338
(715) 392-9520
(715) 392-9521
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
1485704040
WI
Other
Enumeration date
10/14/2020
Last updated
10/14/2020
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