Individual
MR. WAYNE BRUCE GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MED, CSAC
Contact information
Practice address
102 HERITAGE WAY NE STE 302, LEESBURG, VA 20176-4544
(703) 771-5100
(703) 777-0170
Mailing address
37202 BOLYN RD, PURCELLVILLE, VA 20132-4111
(540) 338-5432
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0710101151
VA
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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