Individual
MR. JACOB EDWARD GANSNEDER VIII
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MASSAGE THERAPIST
Contact information
Practice address
3242 AVEBURY LN, KESWICK, VA 22947-9103
(434) 981-4968
Mailing address
3242 AVEBURY LN, KESWICK, VA 22947-9103
(434) 981-4968
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0019008724
VA
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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