# MR. JEREMY SCOTT VANDEHURST

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1861027625
- **Gender:** Man
- **Credential:** L-AT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174H00000X | Health Educator | 0506428 | NV | — |
| 207PS0010X | Sports Medicine (Emergency Medicine) Physician | 0506428 | NV | Yes |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | 0506428 | NV | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | 0506428 | NV | — |
| 226300000X | Kinesiotherapist | 0506428 | NV | — |
| 405300000X | Prevention Professional | 0506428 | NV | — |

## Other

- **Enumeration date:** 03/11/2020
- **Last updated:** 03/11/2020