Individual
JEREMIAH LEE GILLETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
322 CAHALEN ST, CROOKSVILLE, OH 43731-1302
(740) 982-3229
(740) 982-3229
Mailing address
322 CAHALEN ST, CROOKSVILLE, OH 43731-1302
(740) 982-3229
(740) 982-3229
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2359942
—
OH
Enumeration date
01/11/2007
Last updated
07/09/2007
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