Individual
DR. NEAL S JESSUP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2205 ORANGE AVE NE, ROANOKE, VA 24012-8305
(540) 343-2197
(540) 343-3575
Mailing address
PO BOX 488, VINTON, VA 24179-0488
(540) 343-2197
(540) 343-3575
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001553
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010220131
—
VA
Enumeration date
08/03/2005
Last updated
06/20/2018
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