NPI 1992063697

Jeremy Ray Tjarks, MSLATATC

Practitioner Other Specialist/Technologist Springfield, MO

Practice location

Address: 2135 S Fremont Ave, Springfield, MO 65804-2239
Phone: (417) 820-7990
Mailing address: 2349 W Nottingham St, Springfield, MO 65810-2298

Registered specialties

Other Specialist/Technologist Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 246Z00000X Licence 2009024749 (MO)

Other Specialist/Technologist, Other providers in Missouri →

Registry record

NPI: 1992063697
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 May 2012
Record last updated: 1 May 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.