Individual
MR. JEREMY H PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
622 W POPLAR AVE, SUITE 5, COLLIERVILLE, TN 38017-6503
(901) 850-5426
(901) 850-5226
Mailing address
622 W POPLAR AVE, SUITE 5, COLLIERVILLE, TN 38017-6503
(901) 850-5246
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5704
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1511718
—
TN
01
—
4143886
BCBS
TN
01
—
7750939
AETNA
TN
Enumeration date
03/18/2006
Last updated
12/11/2015
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