Individual
KAYLA DAWN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1515 2ND AVE W, WILLISTON, ND 58801-4108
(701) 572-6766
Mailing address
10767 ND 40, NOONAN, ND 58765
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2276
ND
Other
Enumeration date
09/26/2019
Last updated
09/27/2019
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