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Organization
PAIN AND SLEEP THERAPY CENTER LLC
Active
Organization
PAIN AND SLEEP THERAPY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLY MARIE JACOBS DDS (CHIEF CLINICAL DIRECTOR)
(302) 299-5617
Entity
Organization
Contact information
Practice address
1149 W LANCASTER AVE SPC U-5, BRYN MAWR, PA 19010-2722
(302) 299-5617
Mailing address
620 CHURCHMANS RD STE 203, NEWARK, DE 19702-1945
(302) 299-5617
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
NULL
1223D0001X
Public Health Dentistry
Primary
—
—
Other
Enumeration date
03/21/2022
Last updated
03/21/2022
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