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General NPI Number Information
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NPI Number | 1558774042
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Entity Type | Individual
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Provider Name | DAVID GILMORE
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Gender | Male
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Dates
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Enumeration Date | 06/03/2014
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Last Update Date | 03/16/2015
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Provider Practice Location Address
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Address Line | 109 OMEGA CIR
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City | WERNERSVILLE
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State | PA
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Zip | 19565-1644
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Country | US
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Telephone | 484-769-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 1 MAIN STREET
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City | FLEETWOOD
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State | PA
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Zip | 19522
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Country | US
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Telephone | 610-944-0455
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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