Individual
JUANITO GERALDOY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10471 WATERFORD RD, TRAVERSE CITY, MI 49684-6230
(231) 631-2266
Mailing address
10471 WATERFORD RD, TRAVERSE CITY, MI 49684-6230
(231) 631-2266
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009840
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501009840
PT LICENSE
MI
Enumeration date
11/04/2013
Last updated
11/04/2013
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