Individual
JARED PULLIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
542 16TH ST, RAWLINS, WY 82301-5241
(307) 324-2759
Mailing address
812 WATTEN LN, WESTERVILLE, OH 43081-3777
(614) 312-7087
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT-1425
WY
225XG0600X
Gerontology Occupational Therapist
—
—
Other
Enumeration date
11/20/2018
Last updated
07/18/2019
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