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JEREMIAH PHILOGENE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
404 KING SPRINGS VILLAGE PKWY SE, SMYRNA, GA 30082-4240
(770) 432-4444
Mailing address
5091 LINDA VISTA DR SW, MABLETON, GA 30126-2013
(239) 273-1688

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
002869
GA

Other

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