Individual
PHILLIP ANTHONY HOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
3585 BRAMLETON, ROANOKE, VA 24018-2840
(540) 776-1029
Mailing address
3585 BRAMLETON, ROANOKE, VA 24018-2840
(540) 776-1029
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000112
VA
Other
Enumeration date
02/03/2013
Last updated
06/10/2016
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