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Individual

ADAM S JACOBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
1033 GALLIA ST, PORTSMOUTH, OH 45662-4140
(740) 354-5001
(740) 354-5011
Mailing address
PO BOX 1240, ASHLAND, KY 41105-1240
(606) 325-7955
(606) 325-9848

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTA04217
OH

Other

Enumeration date
09/08/2009
Last updated
09/08/2009
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