Jeremy Shane Tackett, PTA
NPI #1043412364 in Checotah, Oklahoma
Provider Information
- NPI Number
- 1043412364
- Entity Type
- Individual
- Name
- Jeremy Shane Tackett, PTA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physical Therapy Assistant
- Credential
- PTA
- Enumeration Date
- May 31, 2007
- Last Updated
- Jul 8, 2007
Practice Location
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapy Assistant |
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