Provider Demographics
NPI:1568707917
Name:GORMAN, KATHERINE A (DC)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:A
Last Name:GORMAN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2506 CROSSING CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7955
Mailing Address - Country:US
Mailing Address - Phone:231-421-3333
Mailing Address - Fax:231-421-3355
Practice Address - Street 1:2506 CROSSING CIR
Practice Address - Street 2:SUITE A
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7955
Practice Address - Country:US
Practice Address - Phone:231-421-3333
Practice Address - Fax:231-421-3355
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI2301009912111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor