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Individual

MICHAEL GORSCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2425 W UNIVERSITY BLVD STE 100, DURANT, OK 74701-2970
(580) 924-7331
(580) 924-7332
Mailing address
2425 W UNIVERSITY BLVD STE 100, DURANT, OK 74701-2970
(580) 924-7331
(580) 924-7332

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
171M00000X
Case Manager/Care Coordinator

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100728830
OK
Enumeration date
05/06/2020
Last updated
10/07/2022
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