Individual
JERMAINE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2918 11TH ST, PORT ARTHUR, TX 77642-4801
(409) 543-1799
Mailing address
2918 11TH ST, PORT ARTHUR, TX 77642-4801
(409) 543-1799
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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