Individual
JEREMY VEINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
9525 N BEACH ST STE 413, FORT WORTH, TX 76244-6438
(817) 502-7411
(817) 502-7412
Mailing address
1110 E STATE HIGHWAY 114 STE 100, SOUTHLAKE, TX 76092-5251
(817) 502-4211
(817) 502-7412
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2148492
TX
Other
Enumeration date
09/18/2023
Last updated
09/18/2023
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