Organization
JESSE CALLOWAY'S FAMILY SERVICES
Active
Other names
Jesse James-DIR
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JESSE JAMES CALLOWAY MENTAL THERAPIST (DIRECTOR/OWNER)
(434) 229-1912
Entity
Organization
Contact information
Practice address
1129 COSBY ST, LYNCHBURG, VA 24504
(434) 229-1912
Mailing address
1129 COSBY STREET, LYNCHBURG, VA 24504
(434) 229-1912
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
31205001
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4944216
—
VA
Enumeration date
04/08/2008
Last updated
07/31/2008
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