Individual
GENNA FUSCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6823 SHOREBROOK DR, SHELBY TWP, MI 48316-5090
(586) 255-9711
Mailing address
6823 SHOREBROOK DR, SHELBY TWP, MI 48316-5090
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
004494
OH
Other
Enumeration date
05/12/2017
Last updated
05/12/2017
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