Individual
JACOB MARCUS BENDORF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
580 MASSIE RD, CHARLOTTESVILLE, VA 22903-1738
(735) 492-4434
Mailing address
14814 HUNTING PATH PL, CENTREVILLE, VA 20120-1230
(571) 398-4394
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/01/2025
Last updated
02/01/2025
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