Individual
MR. NATHAN GEORGE DORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C.
Contact information
Practice address
101 SCHOOL ST, REVERE, MA 02151-3001
(508) 642-5383
Mailing address
101 SCHOOL ST, REVERE, MA 02151-3001
(508) 642-5383
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000001566
MA
Other
Enumeration date
12/01/2009
Last updated
12/01/2009
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