Individual
JEREMY DEWAYNE WINBUSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
4608 LAWRENCEVILLE HWY, TUCKER, GA 30084-2903
(678) 519-8555
Mailing address
1371 MIDLAWN DR, DECATUR, GA 30032-2841
(678) 519-8555
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
10/31/2023
Last updated
10/31/2023
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