Individual
COLLEEN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 922-4535
Mailing address
3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107-2644
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
02/27/2023
Last updated
03/28/2024
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