Individual
PHILLIP GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6110 POWERS AVE STE 12, JACKSONVILLE, FL 32217-2256
(904) 859-8859
(904) 508-0236
Mailing address
6110 POWERS AVE STE 12, JACKSONVILLE, FL 32217-2256
(904) 859-8859
(904) 508-0236
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
FL
172A00000X
Driver
GT600672651770
FL
Other
Enumeration date
02/24/2018
Last updated
02/24/2018
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