Organization
DYNAMIC MEDICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN JORSTAD JAKOBSEN DO (MEDICAL DIRECTOR)
(347) 744-8605
Entity
Organization
Contact information
Practice address
25 WILLET AVE, HICKSVILLE, NY 11801-1637
(347) 744-8605
(516) 935-3140
Mailing address
25 WILLET AVE, HICKSVILLE, NY 11801-1637
(347) 744-8605
(516) 935-3140
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
197596
NY
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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