Individual
JEREMIAH WYMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
559 W LONGEST ST, PAOLI, IN 47454-9670
(812) 723-2595
Mailing address
118 MEDICAL DR, CARMEL, IN 46032-2923
(317) 573-1037
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06002743A
IN
Other
Enumeration date
10/22/2008
Last updated
10/22/2008
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