Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 012350 | OH |
NPI | 1053679548 |
---|---|
Provider Name | Mr. Jeremy Robert Girmann |
First Address | Fairfield, OH 45014-2228 |
Second Address | Fairfield, OH 45014-2228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2012 |
Last Update Date | 10/09/2016 |