Individual
JAYSON VITTORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660
(423) 968-1144
Mailing address
3053 W STATE ST, BRISTOL, TN 37620-1720
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
052750
CT
2085R0202X
Diagnostic Radiology Physician
Primary
52709
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/24/2009
Last updated
10/26/2018
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