Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Jack Aaron Bolen, COTA

Individual provider Occupational Therapy Assistant · NPI 1780907402

Mr. Jack Aaron Bolen, COTA is an Occupational Therapy Assistant in Radford, Virginia. Licensed in Virginia. Registered with an NPI since 2010.

Licensed in
VA
In the registry since
2010
What do these letters mean?
COTA — Certified Occupational Therapy Assistant
Delivers treatment under an occupational therapist's direction.

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Practice location Address checks out

700 Randolph St
Radford, VA 24141-2430
Phone: (540) 633-6533
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Occupational Therapy Assistant (primary) Taxonomy 224Z00000X · Licence 0131000124 (VA)

Record details

NPI number1780907402
Entity typeIndividual (Type 1)
GenderMale
Credentials COTA
Sole proprietorNo
NPI enumeratedMarch 9, 2010
Last updated in NPPESMarch 9, 2010

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