Individual
JEREMY ETISOMBA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
11440 ROSE LN, CINCINNATI, OH 45246-2922
(513) 667-6033
Mailing address
11440 ROSE LN, CINCINNATI, OH 45246-2922
(513) 667-6033
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT010001
OH
Other
Enumeration date
03/14/2018
Last updated
02/06/2025
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