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Individual

JOSEPH ELAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
5303 GARNER ST, SPRINGFIELD, VA 22151-3108
(386) 405-8599
Mailing address
5303 GARNER ST, SPRINGFIELD, VA 22151-3108
(386) 405-8599

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131001259
VA

Other

Enumeration date
01/29/2014
Last updated
01/29/2014
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