Individual
MR. JACOB THOMAS DELLINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
3708 NORTHSIDE DR, SUITE D, MACON, GA 31210-2404
(478) 745-4206
Mailing address
3708 NORTHSIDE DR, MACON, GA 31210-2404
(478) 745-4206
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT011005
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT011005
STATE LICENSE #
GA
Enumeration date
06/21/2013
Last updated
03/04/2015
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