Individual
JEREMY LEE GARLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
49 CHAUCER LN, FAIRFIELD, CA 94533-6545
(707) 386-3046
Mailing address
49 CHAUCER LN, FAIRFIELD, CA 94533-6545
(707) 386-3046
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
512815
CA
Other
Enumeration date
07/02/2013
Last updated
07/02/2013
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