Individual
JACOB DANIEL BRANNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3707 BRAMBLETON AVE STE 2, ROANOKE, VA 24018
(540) 725-7800
(540) 989-6752
Mailing address
3707 BRAMBLETON AVE STE 2, ROANOKE, VA 24018-3658
(540) 725-7800
(540) 989-6752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110004124
VA
Other
Enumeration date
01/14/2013
Last updated
08/01/2018
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