Individual
MR. RICHARD JASON VITAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
740 LANCASTER RD, AUGUSTA, GA 30909-3206
(706) 481-0342
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT002386
GA
Other
Enumeration date
08/22/2006
Last updated
07/08/2007
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