Individual
DR. STACEY KIMBALL GORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
2101 ELM ST N, FARGO, ND 58102-2417
(701) 239-3700
Mailing address
933 FERNON ST, PHILADELPHIA, PA 19148-1105
(717) 303-9437
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT025859
PA
Other
Enumeration date
12/21/2018
Last updated
01/29/2024
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