Individual
BRIAN GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1810 CONCORD LAKE RD, KANNAPOLIS, NC 28083-6434
(704) 933-3781
Mailing address
1810 CONCORD LAKE RD, KANNAPOLIS, NC 28083-6434
(704) 933-3781
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
6858
NC
Other
Enumeration date
01/13/2012
Last updated
01/13/2012
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