Individual
MS. REGINA RENEE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
19629 NE 23RD ST, HARRAH, OK 73045
(405) 454-0010
(405) 454-0030
Mailing address
PO BOX 746, HARRAH, OK 73045
(405) 454-0010
(405) 454-0030
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
3653
OK
225100000X
Physical Therapist
Primary
3653
OK
Other
Enumeration date
07/24/2006
Last updated
11/08/2019
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