Individual
JEREMY QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
425 W GRAND AVE STE 3003, DAYTON, OH 45405-4722
(937) 294-3628
Mailing address
1 PRESTIGE PL STE 550, MIAMISBURG, OH 45342-6115
(937) 762-1310
(937) 522-8068
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1177469
OH
Other
Enumeration date
09/01/2022
Last updated
12/29/2022
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