Individual
PAUL JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 455-0102
Mailing address
520 SUPERIOR ST, PORT HURON, MI 48060-3838
(810) 455-0102
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/14/2017
Last updated
08/14/2017
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