MEDICARE: GORKO PC

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	111N00000X	Chiropractor	5212	AZ

General Provider Information

NPI Number	:	1346552601
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GORKO PC

Provider Business Mailing Address
First Line	:	21050 N TATUM BLVD
Second Line	:	SUITE 202
City	:	PHOENIX
State	:	AZ
Zip	:	85050-4260
Country	:	US
Telephone Number	:	602-788-1600
Fax Number	:	480-515-5444

Provider Business Practice Location Address
First Line	:	21050 N TATUM BLVD
Second Line	:	SUITE 202
City	:	PHOENIX
State	:	AZ
Zip	:	85050-4260
Country	:	US
Telephone Number	:	602-788-1600
Fax Number	:	480-515-5444

Authorized Official
Title or Position	:	PRESIDENT / SECRETARY
Name	:	RAMSEY D GORDON
Credential	:	D.C.
Telephone Number	:	602-788-1600

Provider Enumeration Date	:	07/02/2010
Last Update Date	:	07/02/2010

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Directions to “GORKO PC ” Practice Location

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