Individual
HOLLY JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
15075 CAPITAL ONE DR, RICHMOND, VA 23238-1122
(804) 855-6000
(804) 548-2035
Mailing address
15075 CAPITAL ONE DR, RICHMOND, VA 23238-1122
(804) 855-6000
(804) 548-2035
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
225200000X
VA
Other
Enumeration date
12/31/2014
Last updated
12/31/2014
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