Individual
GREGORY JAMES DERAMUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
108 FOX CHASE LN, FOREST, VA 24551-2514
(434) 401-6338
Mailing address
108 FOX CHASE LANE, FOREST, VA 24551-2514
(434) 401-6338
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306602481
VA
Other
Enumeration date
08/12/2015
Last updated
08/12/2015
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