Individual
MR. ADAM T GOMOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
2601 COOLIDGE RD STE 200, EAST LANSING, MI 48823-6381
(517) 203-3000
(517) 203-3003
Mailing address
801 YORK ST, MANITOWOC, WI 54220-4630
(920) 663-9008
(920) 684-1439
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005313
MI
Other
Enumeration date
02/21/2006
Last updated
06/09/2022
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