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Individual

CHANCE GAUGE RYAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMBT

Contact information

Practice address
9905 SANDY ROCK PL STE B&D, CHARLOTTE, NC 28277-7734
(704) 541-2600
Mailing address
5811 MARKET WAY DR APT 3104, CHARLOTTE, NC 28277-4936
(970) 734-3094

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
07961
NC
225700000X
Massage Therapist
135843
TX
225700000X
Massage Therapist
15659
CO

Other

Enumeration date
09/18/2023
Last updated
09/18/2023
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