Individual
JACOB MASUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
564 NE HIGHWAY 99W, MCMINNVILLE, OR 97128-2707
(503) 472-0096
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
65358
OR
225100000X
Physical Therapist
—
IN
225100000X
Physical Therapist
—
—
Other
Enumeration date
02/19/2024
Last updated
06/25/2024
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