Breanna N Gore
Technician, Other in Ypsilanti, MI. Individual provider (NPI-1).
NPI number1003350570
StatusActive
Last updated in NPPESDec 18, 2016
Details
- NPI
- 1003350570
- Entity type
- Individual (NPI-1)
- Name
- Breanna N Gore
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 18, 2016
- Last updated
- Dec 18, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | – | – | Yes |
Practice location
2080 Whittaker Rd # 164Ypsilanti, MI 48197-8238
Phone 734-796-0259
Mailing address
2080 Whittaker Rd # 164Ypsilanti, MI 48197-8238
Phone 734-796-0259
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