Individual
JEREMY GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4201 WALNUT ST, MCKEESPORT, PA 15132-7300
(412) 664-1448
Mailing address
4201 WALNUT ST, MCKEESPORT, PA 15132-7300
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OP006146
PA
Other
Enumeration date
12/20/2019
Last updated
12/20/2019
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