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1255566154
TEDDIE WAYNE GORE
GREENVILLE, NC
NPI
1255566154
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NC 5004377)
Enumeration Date
2009-05-20
Last Update Date
2009-05-20
Business Address
Mr. TEDDIE WAYNE GORE FNP
2100 STANTONSBURG ROAD ECHI AT PCMH
GREENVILLE, NC 27835
Phone number: 252-847-2181
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Mailing Address
Mr. TEDDIE WAYNE GORE FNP
PO BOX 8423
GREENVILLE, NC 27835-8423
Phone number: 252-847-2181
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