Individual
KIMBERLY ELIZABETH GANIERE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.T.
Contact information
Practice address
32952 SW KEYS CREST DR, SCAPPOOSE, OR 97056-2629
(503) 543-8865
Mailing address
32952 SW KEYS CREST DR, SCAPPOOSE, OR 97056-2629
(503) 543-8865
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
7975
OR
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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