Individual
JEREMY TATE JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1637 PERRYVILLE RD., BOYLE COUNTY HIGH SCHOOL, DANVILLE, KY 40422
(859) 236-5047
(859) 236-6826
Mailing address
1637 PERRYVILLE RD., BOYLE COUNTY HIGH SCHOOL, DANVILLE, KY 40422
(859) 236-5047
(859) 236-6826
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT907
KY
Other
Enumeration date
05/14/2015
Last updated
05/14/2015
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