Individual
JEREMY HAYNES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1105 53RD AVE E, BRADENTON, FL 34203-4897
(941) 755-2562
Mailing address
1105 53RD AVE E, BRADENTON, FL 34203-4897
(941) 755-2562
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 26066
FL
Other
Enumeration date
05/16/2016
Last updated
05/16/2016
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