Individual
MR. SAMUEL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
4348 LEATHERWOOD TER, BURTONSVILLE, MD 20866-1329
(240) 418-5609
Mailing address
4348 LEATHERWOOD TER, BURTONSVILLE, MD 20866-1329
(240) 418-5609
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN1005338
DC
Other
Enumeration date
05/22/2012
Last updated
05/22/2012
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