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Individual

JEREMIAH MOBLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBID, ATC

Contact information

Practice address
536 NEWNAN ST, CARROLLTON, GA 30117-3344
(770) 577-2360
Mailing address
536 NEWNAN ST, CARROLLTON, GA 30117-3344
(770) 577-2360

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
AT001625
GA
237700000X
Hearing Instrument Specialist
Primary
HAA000150
GA

Other

Enumeration date
05/20/2016
Last updated
10/01/2019
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