Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 0119005205 | VA |
Y | 225XG0600X | Occupational Therapist - Gerontology | OT0100006766 | DC |
N | 225XG0600X | Occupational Therapist - Gerontology | OTR2083 | AR |
NPI | 1558651109 |
---|---|
Provider Name | Mr. Jeremy Ryan Furniss |
First Address | Washington, DC 20011-7909 |
Second Address | Washington, DC 20011-7909 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2011 |
Last Update Date | 05/02/2013 |