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Individual

MR. MICHEAL G GORE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MSSA, MSW, LISW

Contact information

Practice address
130 BROAD ST, SUMTER, SC 29150-4237
(803) 467-1263
(803) 774-4378
Mailing address
130 BROAD ST, SUMTER, SC 29150-4237
(803) 467-1263
(803) 774-4378

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6773
SC

Other

Enumeration date
04/08/2016
Last updated
01/09/2017
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