Individual
JACOB LANDRAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4396 BRIARCLIFF RD NE, ATLANTA, GA 30345-2155
(256) 783-1871
Mailing address
4396 BRIARCLIFF RD NE, ATLANTA, GA 30345-2155
(256) 783-1871
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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