Nichols, Jeremiah Tate

Nichols, Jeremiah Tate is an sole proprietor health care provider with primary practice located at 147 Reinhardt College Pkwy Ste 9 , Canton GA 30114-5295. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant is his primary health care specialty. Nichols, Jeremiah Tate can be contacted via phone (770) 345-3057.

Contact Information

Primary practice address
147 Reinhardt College Pkwy Ste 9 Canton GA 30114-5295
Phone: (770) 345-3057
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X AT002223 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X PTA004362 Georgia

Profile Details

NPI number 1225784259
LBN Legal business name Nichols, Jeremiah Tate
Credentials PTA, LAT, ATC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2022
Last updated Feb 28th, 2022 - about 3 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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