Individual
STACEY GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
26 OFFICE PARK DR, JACKSONVILLE, NC 28546-7325
(910) 577-3355
Mailing address
251 MARSH HAVEN DR, SNEADS FERRY, NC 28460-7549
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A2938
NC
Other
Enumeration date
12/30/2014
Last updated
03/16/2026
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