Individual
VIRGINIA SUE GAUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
500 E ROUND GROVE RD, ROOM #11, LEWISVILLE, TX 75067-8309
(214) 679-7497
Mailing address
PO BOX 3904, COPPELL, TX 75019-4440
(214) 679-7497
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT123416
TX
Other
Enumeration date
12/24/2015
Last updated
12/24/2015
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