Individual
SHEREE GANSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2520 LAKE TAHOE BLVD STE 5, SOUTH LAKE TAHOE, CA 96150-7726
(530) 314-1724
Mailing address
1690 SKYLINE DR, SOUTH LAKE TAHOE, CA 96150-4915
(530) 314-1724
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
CAMTC 28155
CA
225700000X
Massage Therapist
MA58085
FL
225700000X
Massage Therapist
NVMT 5570
NV
Other
Enumeration date
12/06/2012
Last updated
09/10/2014
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