Organization
MARTIN JACOBSON, D.C., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN JACOBSON D.C. (OWNER)
(321) 725-7003
Entity
Organization
Contact information
Practice address
1051 PORT MALABAR BLVD NE, SUITE 2, PALM BAY, FL 32905-5153
(321) 725-7003
Mailing address
1051 PORT MALABAR BLVD. NE, SUITE 2, PALM BAY, FL 32905
(321) 725-7003
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
CH0004008
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051196000
—
FL
Enumeration date
03/26/2012
Last updated
03/26/2012
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