Individual
MR. JEREMY DAVID HELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, ATC, PES, CES
Contact information
Practice address
1467 WAYNE AVE, LAKEWOOD, OH 44107-3422
(216) 712-7818
Mailing address
1467 WAYNE AVE, LAKEWOOD, OH 44107-3422
(216) 712-7818
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 002688
OH
Other
Enumeration date
05/14/2013
Last updated
05/14/2013
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