Individual
DR. MICHAEL LEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1150 RESERVOIR AVE, SUITE 103, CRANSTON, RI 02920-6068
(401) 942-2625
(401) 942-3097
Mailing address
370 HILL ST, COVENTRY, RI 02816-7725
(401) 823-6724
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2492
RI
Other
Enumeration date
03/06/2013
Last updated
03/06/2013
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