Provider Demographics
NPI:1801653431
Name:GRABER, JEREMY JACOB
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:JACOB
Last Name:GRABER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 CHERRY ST E
Mailing Address - Street 2:
Mailing Address - City:CANAL FULTON
Mailing Address - State:OH
Mailing Address - Zip Code:44614-1129
Mailing Address - Country:US
Mailing Address - Phone:330-802-8026
Mailing Address - Fax:
Practice Address - Street 1:334 CHERRY ST E
Practice Address - Street 2:
Practice Address - City:CANAL FULTON
Practice Address - State:OH
Practice Address - Zip Code:44614-1129
Practice Address - Country:US
Practice Address - Phone:330-802-8026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide