Provider Demographics
NPI:1922836873
Name:GAMOKE, ALLISON (DC)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:
Last Name:GAMOKE
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 1:3001 HARBOR LN N STE 170
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-5137
Mailing Address - Country:US
Mailing Address - Phone:763-838-5109
Mailing Address - Fax:
Practice Address - Street 1:3001 HARBOR LN N STE 170
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-5137
Practice Address - Country:US
Practice Address - Phone:763-383-5109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN6326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor