Individual
DOMINIQUE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
200 SAINT CHARLES PL, SAINT MARYS, GA 31558-3913
(912) 439-0207
Mailing address
200 SAINT CHARLES PL, SAINT MARYS, GA 31558-3913
(912) 439-0207
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
02/26/2014
Last updated
02/26/2014
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