Individual
JEREMY LUKE PEVAHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
73 EDMOND RD STE 2, KEARNEYSVILLE, WV 25430-2793
(681) 252-4685
Mailing address
95 MISTALA CT, INWOOD, WV 25428-3832
(304) 283-9757
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002009
WV
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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