Individual
LAUREN VISTARAKULA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4335 BRAMBLETON AVE, ROANOKE, VA 24018-3404
(540) 315-3210
(540) 566-5149
Mailing address
4335 BRAMBLETON AVE, ROANOKE, VA 24018-3404
(540) 315-3210
(540) 566-5149
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119007276
VA
Other
Enumeration date
07/05/2020
Last updated
01/30/2024
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