Individual
JEREMY OLDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
208 PENNKNOLL RD, EVERETT, PA 15537-6940
(814) 623-3240
Mailing address
688 E WATSON ST, BEDFORD, PA 15522-2106
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A2867
MD
225200000X
Physical Therapy Assistant
Primary
TEI000994
PA
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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