Individual
JOHN JULIUS GERIDEAU III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT, MLD
Contact information
Practice address
151 WATERLOO ST SW, AIKEN, SC 29801-3756
(877) 462-1827
Mailing address
708 DAVIS TER NW, AIKEN, SC 29801-4036
(877) 462-1827
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
9586
SC
Other
Enumeration date
12/14/2023
Last updated
12/14/2023
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