Individual
JARED TYLER WHITTAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 N JEFFERSON ST, ROANOKE, VA 24016-1427
(540) 293-8087
Mailing address
650 N JEFFERSON ST, ROANOKE, VA 24016-1427
(540) 345-5111
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131003017
VA
Other
Enumeration date
06/03/2025
Last updated
06/03/2025
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