Individual
MRS. JESSICA JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2693 BROOKSEDGE VW, COLORADO SPRINGS, CO 80910-4454
(719) 330-0029
Mailing address
2693 BROOKSEDGE VW, COLORADO SPRINGS, CO 80910-4454
(719) 330-0029
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013986
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0013986
—
CO
Enumeration date
10/10/2016
Last updated
10/10/2016
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