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Individual
MR. JEREMY STEWART
Active
Individual
MR. JEREMY STEWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT19380
FL
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT-19380
STATE OF FL. PT LICENSE NUMBER
FL
Enumeration date
06/13/2006
Last updated
05/26/2011
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