Provider Demographics
NPI:1073963682
Name:ZECH, JEREMIAH (PTA)
Entity Type:Individual
Prefix:
First Name:JEREMIAH
Middle Name:
Last Name:ZECH
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 SEVEN VALLEYS RD
Mailing Address - Street 2:
Mailing Address - City:SEVEN VALLEYS
Mailing Address - State:PA
Mailing Address - Zip Code:17360-9137
Mailing Address - Country:US
Mailing Address - Phone:717-818-6637
Mailing Address - Fax:
Practice Address - Street 1:2644 SEVEN VALLEYS RD
Practice Address - Street 2:
Practice Address - City:SEVEN VALLEYS
Practice Address - State:PA
Practice Address - Zip Code:17360-9137
Practice Address - Country:US
Practice Address - Phone:717-818-6637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-14
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATEI003255225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant