Healthcare Provider Details

I. General information

NPI: 1578008231
Provider Name (Legal Business Name): DR. KATHERINE A GORMAN DC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 01/04/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2506 CROSSING CIR STE A
TRAVERSE CITY MI
49684-7955
US

IV. Provider business mailing address

2506 CROSSING CIR STE A
TRAVERSE CITY MI
49684-7955
US

V. Phone/Fax

Practice location:
  • Phone: 231-421-3333
  • Fax: 231-421-3355
Mailing address:
  • Phone: 231-421-3333
  • Fax: 231-421-3355

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009912
License Number StateMI

VIII. Authorized Official

Name: DR. KATHERINE GORMAN
Title or Position: OWNER/DOCTOR OF CHIROPRACTIC
Credential: D.C.
Phone: 231-421-3333