Individual
JOSEPH VERNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA/L
Contact information
Practice address
1 SUTPHIN DR, MARMET, WV 25315-1977
(304) 949-1580
(304) 949-4880
Mailing address
175 HIGH ST, FAYETTEVILLE, WV 25840-1135
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
C1690
WV
Other
Enumeration date
05/27/2009
Last updated
05/27/2009
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