Individual
JEREMY E DETAMPLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3953 ROOSEVELT BLVD APT B, MIDDLETOWN, OH 45044-6627
(513) 291-5671
Mailing address
7171 KECK PARK CIR NW, NORTH CANTON, OH 44720-6301
(330) 498-8200
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA006100
OH
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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