DR. Jeremiah Michael Light

NPI #1366046617 in Converse, Texas

Provider Information

NPI Number: 1366046617
Entity Type: Individual
Name: DR. Jeremiah Michael Light
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Enumeration Date: Nov 27, 2020
Last Updated: Nov 27, 2020

Practice Location

Address: 10781 TOEPPERWEIN RD
City: Converse
State: Texas
ZIP Code: 78109-2561
Phone: (210) 672-6812

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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