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1053368738
FORREST D GORTER
PHOENIX, AZ
NPI
1053368738
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AZ 1023)
Enumeration Date
2006-05-28
Last Update Date
2007-07-08
Business Address
-- FORREST D GORTER PAC
1441 N 12TH ST
PHOENIX, AZ 85006-2837
Phone number: 602-747-4577
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Mailing Address
-- FORREST D GORTER PAC
150 S 12TH ST
PHOENIX, AZ 85034-2301
Phone number: 602-495-5797
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