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Individual

MR. JEREMY CRAIG DECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA/L

Contact information

Practice address
1180 HAYWOOD RD, GREENVILLE, SC 29615-2286
(864) 288-8093
Mailing address
147 COLDSTREAM DR, SPARTANBURG, SC 29316-5101
(864) 590-5316

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3196
SC

Other

Enumeration date
06/16/2013
Last updated
06/16/2013
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