Individual
ASHLEY GORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
213 KEENAN AVE APT A204, UNION, SC 29379-2281
(803) 627-0332
Mailing address
213 KEENAN AVE APT A204, UNION, SC 29379-2281
(803) 627-0332
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
05321
SC
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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