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General NPI Number Information
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NPI Number | 1205161163
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Entity Type | Individual
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Provider Name | JEREMY DUANE HOUSER DPT, OCS
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Gender | Male
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Dates
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Enumeration Date | 10/12/2009
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 680 S 9TH ST STE A
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City | GRIFFIN
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State | GA
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Zip | 30224-4216
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Country | US
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Telephone | 707-229-6141
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Fax |
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Provider Business Mailing Address
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Address Line | 680 S 9TH ST STE A
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City | GRIFFIN
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State | GA
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Zip | 30224-4216
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Country | US
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Telephone | 707-229-6141
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05011697A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTH5625
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License Number State | AL
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT009785
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License Number State | GA
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