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JEREMY RAYMOND DICUS

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
AT

Contact information

Practice address
OHIO UNIVERSITY, GROVER CENTER E207, ATHENS, OH 45701-2979
(740) 593-9497
Mailing address
1268 SHERIDAN DR, APARTMENT H, LANCASTER, OH 43130-1940
(740) 821-2775

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002554
OH

Other

Enumeration date
02/07/2006
Last updated
07/08/2007
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