Individual
JACQUELYN O JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3630 HICKORY RD, MISHAWAKA, IN 46545-8865
(574) 252-7225
Mailing address
1609 S 15TH ST, GOSHEN, IN 46526-4558
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/20/2022
Last updated
09/20/2022
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