Healthcare Provider Details

I. General information

NPI: 1205793148
Provider Name (Legal Business Name): JEREMY LYNN SAYNE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2026
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

212 N PIERCE AVE APT D
LANCASTER OH
43130-3634
US

IV. Provider business mailing address

212 N PIERCE AVE APT D
LANCASTER OH
43130-3634
US

V. Phone/Fax

Practice location:
  • Phone: 740-974-9198
  • Fax: 614-368-9168
Mailing address:
  • Phone: 740-974-9198
  • Fax: 614-368-9168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberAPS.007275
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: