Individual
NICOLE R GANOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12581 MILSTEAD WAY, WOODBRIDGE, VA 22192-5445
(703) 239-7336
Mailing address
8663 WOODWARD RD, MARSHALL, VA 20115-3349
(703) 932-1161
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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