Individual
MR. DAVID GORRELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
210 N MAIN ST, LONDON, OH 43140-1115
(740) 852-6256
(740) 852-6395
Mailing address
210 N MAIN ST, LONDON, OH 43140-1115
(740) 852-6256
(740) 852-6395
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
E0000957
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375381
ANTHEM
OH
Enumeration date
10/31/2005
Last updated
07/08/2007
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