Provider Demographics
NPI:1760052096
Name:GILLMAN-GOSS, COLE HUNTER (ATC)
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:HUNTER
Last Name:GILLMAN-GOSS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1112 REPUBLIC CIR
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-5382
Mailing Address - Country:US
Mailing Address - Phone:785-743-8610
Mailing Address - Fax:
Practice Address - Street 1:102 W WILSON ST
Practice Address - Street 2:
Practice Address - City:WINGATE
Practice Address - State:NC
Practice Address - Zip Code:28174-6747
Practice Address - Country:US
Practice Address - Phone:785-743-8610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer