Individual
GENALEE FERGUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
8500 EXECUTIVE PARK AVE STE 300, FAIRFAX, VA 22031-2228
(571) 276-5148
Mailing address
44121 HARRY BYRD HWY STE 255, ASHBURN, VA 20147-5671
(571) 276-5148
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019010592
VA
Other
Enumeration date
06/23/2022
Last updated
09/27/2023
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