Individual
JEREMY PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3300 POINSETT HWY, GREENVILLE, SC 29613-2504
(864) 294-3553
(864) 294-3339
Mailing address
4113 ENCLAVE PARIS DR, GREENVILLE, SC 29609-1351
(770) 335-1191
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT03240
SC
2255A2300X
Athletic Trainer
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000041105
BOC NUMBER
—
Enumeration date
07/02/2019
Last updated
11/02/2022
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