Individual
JACOB M NYGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED
Contact information
Practice address
135 S MAIN ST, MARION, NC 28752-4548
(828) 652-1989
(828) 652-8990
Mailing address
PO BOX 975, MARION, NC 28752-0975
(828) 652-1989
(828) 652-8990
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7795082
—
NC
Enumeration date
05/30/2007
Last updated
07/09/2007
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