Individual
JACOB EVAN NEEDHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
377 CLONCE ST, WEBER CITY, VA 24290-7269
(276) 477-5640
Mailing address
377 CLONCE ST, WEBER CITY, VA 24290-7269
(276) 477-5640
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119009809
VA
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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