Individual
JASON LEE BECKENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(800) 422-8482
Mailing address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 985-6920
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006511
VA
Other
Enumeration date
12/20/2018
Last updated
08/12/2021
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