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Individual

MR. JEREMIAH HOSEA DENARD CHAMBLISS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
112 POST OAK RD, YORKTOWN, VA 23693-4967
(727) 637-2178
Mailing address
3435 7TH AVE SE, LARGO, FL 33771-2726
(727) 637-2178

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119009433
VA
225X00000X
Occupational Therapist
OT16304
FL

Other

Enumeration date
05/06/2020
Last updated
05/10/2023
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