Provider Demographics
NPI:1891045159
Name:VONDRUSKA, ANNE (LMT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:VONDRUSKA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 US HIGHWAY 395 N
Mailing Address - Street 2:SUITE#D
Mailing Address - City:GARDNERVILLE
Mailing Address - State:NV
Mailing Address - Zip Code:89410-5270
Mailing Address - Country:US
Mailing Address - Phone:775-443-7888
Mailing Address - Fax:
Practice Address - Street 1:1516 US HIGHWAY 395 N
Practice Address - Street 2:SUITE#D
Practice Address - City:GARDNERVILLE
Practice Address - State:NV
Practice Address - Zip Code:89410-5270
Practice Address - Country:US
Practice Address - Phone:775-443-7888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV5053111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0100XChiropractic ProvidersChiropractorOccupational Health