Individual
MARTIN A JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1160 KEPLER DR, GREEN BAY, WI 54311-8321
(920) 288-5656
(920) 288-5657
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2782
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38871600
—
WI
Enumeration date
06/21/2006
Last updated
09/19/2023
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