Individual
JASON DZIAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS OTR/L
Contact information
Practice address
PO BOX 4566, BRIDGEPORT, WV 26330-4566
(304) 439-4506
Mailing address
PO BOX 4566, BRIDGEPORT, WV 26330-4566
(304) 439-4506
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9440123000
—
WV
Enumeration date
03/12/2008
Last updated
09/02/2024
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