Individual
DERICK JERMAINE GERIDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5517 TUNBRIDGE WELLS RD, LITHONIA, GA 30058-5670
(404) 663-8342
Mailing address
5517 TUNBRIDGE WELLS RD, LITHONIA, GA 30058-5670
(404) 663-8342
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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