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NPI Code Detail

MEDICARE: JEREMY KOONTZ PT

MEDICARE:   JEREMY  KOONTZ  PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist17314TN
2225100000XPhysical Therapist008587KY

General Provider Information

NPI Number : 1023749546
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY KOONTZ PT
Provider Business Mailing Address
First Line : 1200 CORPORATE DR STE 400
Second Line :
City : HOOVER
State : AL
Zip : 35242-5424
Country : US
Telephone Number : 423-238-7217
Fax Number :
Provider Business Practice Location Address
First Line : 1010 MONARCH ST STE 150
Second Line :
City : LEXINGTON
State : KY
Zip : 40513-1892
Country : US
Telephone Number : 859-219-0211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2022
Last Update Date : 06/02/2026

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Directions to “ JEREMY KOONTZ PT” Practice Location

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