Individual
MR. DOUG RAY JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CMT
Contact information
Practice address
2961 UPPER PACK RIVER RD, SANDPOINT, ID 83864-4935
(970) 989-3358
Mailing address
2961 UPPER PACK RIVER RD, SANDPOINT, ID 83864-4935
(970) 989-3358
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0016062
CO
Other
Enumeration date
07/21/2025
Last updated
07/21/2025
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