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Individual

JORGE OMAR MENDEZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTAS/L

Contact information

Practice address
4801 PRETTY LAKE AVE, NORFOLK, VA 23518-2038
(757) 982-2143
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131003111
VA

Other

Enumeration date
08/11/2025
Last updated
08/11/2025
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