Individual
JACOB LEE MUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 SAINT CHARLES ST, JASPER, IN 47546-9145
(812) 639-9216
Mailing address
1550 TIMBER LINE DR, HUNTINGBURG, IN 47542-8001
(812) 639-9216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05014242A
IN
Other
Enumeration date
08/09/2021
Last updated
08/09/2021
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