Provider Demographics
NPI:1346397452
Name:GEUS, JEREMY J (ATC, CSCS)
Entity Type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:J
Last Name:GEUS
Suffix:
Gender:M
Credentials:ATC, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 CHADWICK DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-3133
Mailing Address - Country:US
Mailing Address - Phone:205-987-1658
Mailing Address - Fax:
Practice Address - Street 1:806 SAINT VINCENTS DR
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1684
Practice Address - Country:US
Practice Address - Phone:205-939-1557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5382255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer