Mr. GAVIN BLAIR GORE
Individual Provider (NPI-1)
Active
Radiology, Diagnostic Radiology
Provider Information
- NPI Number
1316189608- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 19500 SANDRIDGE WAY, SUITE 420, LEESBURG, VA, 201763467
- Phone
- (571) 375-8601
- Fax
- (571) 223-6773
Specialties & Taxonomies
Radiology, Diagnostic Radiology
License: NC #2013-02510
Student in an Organized Health Care Education/Training Program
Radiology, Diagnostic Radiology
Primary License: VA #0101258174