Individual
KEITH GANCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
501 S SHARON AMITY RD, STE 500, CHARLOTTE, NC 28211-2896
(704) 362-1555
Mailing address
2301 BRANDON CIR, CHARLOTTE, NC 28211-1656
(631) 334-1852
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
4800
NC
Other
Enumeration date
10/17/2012
Last updated
03/14/2017
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