Individual
JEREMY SHIFFLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
133 ENTERPRISE DR, DANVILLE, VA 24540-4071
(434) 792-2907
Mailing address
542 W MAIN ST, DANVILLE, VA 24541-3600
(570) 360-7259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110005087
VA
Other
Enumeration date
10/01/2015
Last updated
10/01/2015
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