King, Jeremy Keith

King, Jeremy Keith is an individual health care provider with primary practice located at 360 Rebels Cir , Blue Ridge GA 30513-8137. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. King, Jeremy Keith can be contacted via phone (706) 455-5134.

Contact Information

Primary practice address
360 Rebels Cir Blue Ridge GA 30513-8137
Phone: (706) 455-5134
Fax: (706) 632-6552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT002001 Georgia

Profile Details

NPI number 1164939849
LBN Legal business name King, Jeremy Keith
Credentials M.ED, LAT, ATC, ITAT
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2018
Last updated Jan 4th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164939849 NPPES
Georgia Other 10001136 NATION ATHLETIC TRAINERS' ASSOCIATION MEMBER NUMBER

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