Individual
JACOB TIMOTHY MACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1527 BROADWAY ST, ALEXANDRIA, MN 56308-2537
(320) 762-0399
(320) 762-6847
Mailing address
PO BOX 2010, FARGO, ND 58122-2484
(701) 234-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12506
MN
363A00000X
Physician Assistant
PA0004552
CO
Other
Enumeration date
02/19/2016
Last updated
03/17/2018
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