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Individual
JACOB DEESE
Active
Individual
JACOB DEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT, ATC
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
P20196
NC
2255A2300X
Athletic Trainer
LAT-2888
NC
Other
Enumeration date
04/19/2017
Last updated
02/09/2021
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