Individual
MR. JESSE TYLER BORTELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10210 REISTERSTOWN RD, OWINGS MILLS, MD 21117-3606
(410) 902-6776
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0006346
MD
Other
Enumeration date
12/20/2016
Last updated
02/11/2021
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