Individual
JEREMY KEITH KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED, LAT, ATC, ITAT
Contact information
Practice address
360 REBELS CIR, BLUE RIDGE, GA 30513-8137
(706) 455-5134
(706) 632-6552
Mailing address
184 BLACKBERRY LN, MORGANTON, GA 30560-3700
(706) 455-5134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT002001
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001136
NATION ATHLETIC TRAINERS' ASSOCIATION MEMBER NUMBER
GA
Enumeration date
01/04/2018
Last updated
01/04/2018
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