Provider Demographics
NPI:1164133401
Name:BRAMLETT, JEREMY D (BS, ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:D
Last Name:BRAMLETT
Suffix:
Gender:M
Credentials:BS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PARADISE LN
Mailing Address - Street 2:
Mailing Address - City:MARS HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28754-9711
Mailing Address - Country:US
Mailing Address - Phone:828-206-1456
Mailing Address - Fax:
Practice Address - Street 1:100 ATHLETIC ST
Practice Address - Street 2:
Practice Address - City:MARS HILL
Practice Address - State:NC
Practice Address - Zip Code:28754-9134
Practice Address - Country:US
Practice Address - Phone:828-206-1456
Practice Address - Fax:828-689-1313
Is Sole Proprietor?:No
Enumeration Date:2022-12-07
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLAT-47672255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer