Individual
JEREMY GALLEGO ASPA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1500 N LOMBARDY ST, RICHMOND, VA 23220-1711
(804) 257-5600
Mailing address
4056 COAL SPRING LN APT 2A, GLEN ALLEN, VA 23060-4362
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0126002107
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000000
EMPLOYER INSURANCE
VA
Enumeration date
09/21/2017
Last updated
09/21/2017
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