Individual
MISS JENNIFER E JACOBSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2200 N PONCE DE LEON BLVD, SUITE 12, ST AUGUSTINE, FL 32084-2600
(904) 392-6588
Mailing address
15A ATLANTIC OAKS CIR, ST AUGUSTINE, FL 32080-6876
(904) 392-6588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 46676
FL
Other
Enumeration date
08/04/2008
Last updated
08/04/2008
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