Individual
JEREMY JACOB SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
32 WINDWARD DR, SUITE 110, FISHERSVILLE, VA 22939-2174
(540) 949-5383
(540) 949-5493
Mailing address
32 WINDWARD DR, SUITE 110, FISHERSVILLE, VA 22939-2174
(540) 949-5383
(540) 949-5493
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305006700
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
190047
ANTHEM BLUE CROSS
VA
Enumeration date
09/16/2006
Last updated
09/24/2010
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