Individual
MRS. CHANTAL JACKQUELINE COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5816 DICKSON RD, JACKSONVILLE, FL 32211-4600
(904) 993-7048
(904) 744-0293
Mailing address
5816 DICKSON RD, JACKSONVILLE, FL 32211-4600
(904) 993-7048
(904) 744-0293
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
PTA 18829
FL
Other
Enumeration date
07/31/2007
Last updated
07/31/2007
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