Provider Demographics
NPI:1205076924
Name:HOWELL, JEREMY L (LPTA)
Entity type:Individual
Prefix:MR
First Name:JEREMY
Middle Name:L
Last Name:HOWELL
Suffix:
Gender:M
Credentials:LPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:956 E CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-4352
Mailing Address - Country:US
Mailing Address - Phone:740-341-5151
Mailing Address - Fax:
Practice Address - Street 1:4351 DALE DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-5403
Practice Address - Country:US
Practice Address - Phone:614-760-1662
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-21
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5846225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant