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NPI Code Detail

MEDICARE: ANDREA GORE PT

MEDICARE:   ANDREA  GORE  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist8498MN

General Provider Information

NPI Number : 1184937351
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA GORE PT
Provider Business Mailing Address
First Line : 800 E 28TH ST
Second Line : SUITE 2704
City : MINNEAPOLIS
State : MN
Zip : 55407-3723
Country : US
Telephone Number : 612-863-4447
Fax Number :
Provider Business Practice Location Address
First Line : 800 E 28TH ST
Second Line : SUITE 2704
City : MINNEAPOLIS
State : MN
Zip : 55407-3723
Country : US
Telephone Number : 612-863-4447
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/16/2010
Last Update Date : 07/16/2010

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Directions to “ ANDREA GORE PT” Practice Location

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