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Individual

STEPHANIE LAUREN GERUSO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, ATC, CSCS, CES,

Contact information

Practice address
211 OLD LEXINGTON RD, THOMASVILLE, NC 27360-3428
(336) 474-8153
Mailing address
6057 WILLOMERE CIR, WINSTON SALEM, NC 27107-3731
(919) 819-6649

Taxonomy

Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
080102265
NC

Other

Enumeration date
11/03/2012
Last updated
10/21/2016
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