Healthcare Provider Details

I. General information

NPI: 1275858946
Provider Name (Legal Business Name): BARRY LEE GOMMER JR. L.AC.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2010
Last Update Date: 04/06/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 KIRKWOOD HWY
NEWARK DE
19711-5716
US

IV. Provider business mailing address

1536 KIRKWOOD HWY
NEWARK DE
19711-5716
US

V. Phone/Fax

Practice location:
  • Phone: 302-454-1230
  • Fax: 302-454-5855
Mailing address:
  • Phone: 302-454-1230
  • Fax: 302-454-5855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: