Breanna N Gore

NPI #1003350570 in Ypsilanti, Michigan

Provider Information

NPI Number: 1003350570
Entity Type: Individual
Name: Breanna N Gore
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Dec 18, 2016
Last Updated: Dec 18, 2016

Practice Location

Address: 2080 WHITTAKER RD # 164
City: Ypsilanti
State: Michigan
ZIP Code: 48197-8238
Phone: (734) 796-0259

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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