Individual
JANISHA GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMBT
Contact information
Practice address
5211 MAIN ST STE 505, SHALLOTTE, NC 28470-3442
(910) 269-9516
Mailing address
2186 FREEDOM STAR RD, LONGWOOD, NC 28452-9779
(910) 269-9516
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18531
NC
Other
Enumeration date
02/09/2021
Last updated
02/09/2021
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