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General NPI Number Information
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NPI Number | 1649810078
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Entity Type | Individual
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Provider Name | JEREMIAH DYER DC
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Gender | Male
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Dates
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Enumeration Date | 01/14/2020
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Last Update Date | 10/02/2020
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Provider Practice Location Address
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Address Line | 9601 E ILIFF AVE APT 1215
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City | DENVER
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State | CO
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Zip | 80231-3449
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Country | US
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Telephone | 317-504-5478
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Fax |
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Provider Business Mailing Address
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Address Line | 33 E COUNTY LINE RD STE A
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City | GREENWOOD
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State | IN
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Zip | 46143-1078
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Country | US
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Telephone | 317-882-4922
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 08003169A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CHR.0008127
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License Number State | CO
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