Individual
NICHOLAS PAUL GERASIMOFF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
22731 NEWMAN ST STE 100B, DEARBORN, MI 48124-2023
(313) 791-0616
(313) 791-0632
Mailing address
12560 JELSO PL, TECUMSEH, ONTARIO N8N4H-4
(519) 735-1898
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201007912
MI
Other
Enumeration date
03/02/2011
Last updated
03/02/2011
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