Individual
JEREMY KYLE WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6110 SHALLOWFORD RD, CHATTANOOGA, TN 37421-1894
(888) 291-4357
Mailing address
213 E PLUM ST, CENTERVILLE, IN 47330-1214
(765) 277-6271
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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