Individual
GREG SCOTT GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
7700 MESQUITE PASS, CONVERSE, TX 78109-2461
(210) 650-0551
Mailing address
12811 EL MARRO ST, SAN ANTONIO, TX 78233-5833
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
08/26/2018
Last updated
08/26/2018
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