JAKE E DIVERS

VINTON, VA
NPI1871942961
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: VA  2305210198)
Enumeration Date2016-06-09
Last Update Date2016-06-09
Business Address
-- JAKE E DIVERS PT, DPT
1110 VINYARD RD
VINTON, VA 24179-3632
Phone number: 540-343-0466
Mailing Address
-- JAKE E DIVERS PT, DPT
1110 VINYARD RD
VINTON, VA 24179-3632
Phone number: 540-343-0466
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