Individual
JARED KENNETH CASAZZA
Active
Individual
JARED KENNETH CASAZZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305209489
VA
225100000X
Physical Therapist
P16639
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2305209489
PHYSICAL THERAPY LICENSE
VA
Enumeration date
09/21/2016
Last updated
03/26/2024
Update your record
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