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Individual

JACOB SPITZMILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
150 GENTILLY BLVD, CARTERSVILLE, GA 30120-8522
(678) 719-7000
Mailing address
PO BOX 441146, KENNESAW, GA 30160-9522
(678) 403-3568

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT013167
LICENSE
GA
Enumeration date
09/29/2017
Last updated
10/20/2017
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