MEDICARE: DR. ANDREW M GORBY DC

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
1	111NX0800X	Orthopedic Chiropractor	3837	AZ
2	111NX0800X	Orthopedic Chiropractor	423	ND

General Provider Information

NPI Number	:	1215933783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREW M GORBY DC

Provider Business Mailing Address
First Line	:	6550 W GLENDALE AVE
Second Line	:	STE 2
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2381
Country	:	US
Telephone Number	:	623-931-9317
Fax Number	:	623-931-9291

Provider Business Practice Location Address
First Line	:	6550 W GLENDALE AVE
Second Line	:	STE 2
City	:	GLENDALE
State	:	AZ
Zip	:	85301-2381
Country	:	US
Telephone Number	:	623-931-9317
Fax Number	:	623-931-9291

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	10/22/2010

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