Individual provider · Type 1 NPI

Jeremiah Tate Nichols, PTA, LAT, ATC

Physical Therapy Assistant · Canton, GA

NPI number 1225784259 Active

Practice location

147 Reinhardt College Pkwy Ste 9
Canton, GA 30114-5295

Call (770) 345-3057 Map

Mailing address

4384 Earney Rd
Woodstock, GA 30188-5600

Specialties and licenses

TaxonomyCodeLicense
Athletic Trainer 2255A2300XAT002223 (GA)
Physical Therapy Assistant Primary 225200000XPTA004362 (GA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

3 other providers at this address

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About NPI 1225784259

Jeremiah Tate Nichols, PTA, LAT, ATC's National Provider Identifier is 1225784259, issued on Feb 28, 2022. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Canton, GA. The record was last updated on Feb 28, 2022.