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Individual

JEREMY REDFEARN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATP

Contact information

Practice address
1432 W 16TH ST, MOUNT PLEASANT, TX 75455-2083
(903) 575-1305
(903) 572-1301
Mailing address
1432 W 16TH ST, MOUNT PLEASANT, TX 75455-2083
(903) 575-1305
(903) 572-1301

Taxonomy

Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010549601
TX
05
010549602
TX
05
010549603
TX
05
016383402
TX
05
079392902
TX
Enumeration date
05/08/2014
Last updated
05/08/2014
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