Individual
MR. DALTON JAMES GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
2214 E FAIRVIEW AVE, JOHNSON CITY, TN 37601-2860
(423) 928-6464
Mailing address
2214 E FAIRVIEW AVE, JOHNSON CITY, TN 37601-2860
(931) 704-5064
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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