Jake E Divers IV, PT, DPT

NPI #1871942961 in Vinton, Virginia

Provider Information

NPI Number: 1871942961
Entity Type: Individual
Name: Jake E Divers IV, PT, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT
Enumeration Date: Jun 9, 2016
Last Updated: Jun 9, 2016

Practice Location

Address: 1110 VINYARD RD
City: Vinton
State: Virginia
ZIP Code: 24179-3632
Phone: (540) 343-0466

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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