Individual
TABITHA LYN GANSKE
Active
Individual
TABITHA LYN GANSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
160.008904
IL
208100000X
Physical Medicine & Rehabilitation Physician
2019027272
MO
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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