Individual
MR. JEREMY R. COAKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
515 GREENE DR, GREENVILLE, KY 42345-1409
(270) 338-5400
Mailing address
515 GREENE DR, GREENVILLE, KY 42345-1409
(270) 338-5400
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02641
KY
Other
Enumeration date
05/05/2011
Last updated
05/05/2011
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