Individual
MISS GABRIELLE BANKSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
191 JONESVILLE AVE, YEMASSEE, SC 29945-4703
(843) 214-8646
Mailing address
191 JONESVILLE AVE, YEMASSEE, SC 29945-4703
(843) 214-8646
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
8955
SC
Other
Enumeration date
07/07/2015
Last updated
05/09/2017
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