Individual
JERRY SWINDELL GANUS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
402 HARRIS AVE, RAEFORD, NC 28376-3112
(910) 875-5590
(910) 875-5008
Mailing address
690 WILTSHIRE RD, FAYETTEVILLE, NC 28314-0743
(704) 219-4483
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2024-9570-01
NC
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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