Provider Demographics
NPI:1285025932
Name:GORE, PAMELA (DC)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:
Last Name:GORE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9901 S WESTERN AVE STE A-1
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2951
Mailing Address - Country:US
Mailing Address - Phone:405-735-1455
Mailing Address - Fax:
Practice Address - Street 1:9901 S WESTERN AVE STE A-1
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2951
Practice Address - Country:US
Practice Address - Phone:405-735-1455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-16
Last Update Date:2018-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3893111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor