Individual
JEREMY WHEELAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6314 WHISKEY CREEK DR, FORT MYERS, FL 33919-8762
(239) 432-0556
Mailing address
6314 WHISKEY CREEK DR, FORT MYERS, FL 33919-8762
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
23500
FL
Other
Enumeration date
09/20/2012
Last updated
09/20/2012
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