Individual
JACOB HENRY BIRKHEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 W KING ST STE 2, KINGS MOUNTAIN, NC 28086-3437
(704) 739-3373
Mailing address
164 W WALNUT AVE, MOUNT HOLLY, NC 28120-1883
(919) 943-8969
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
19139
NC
Other
Enumeration date
06/03/2021
Last updated
06/03/2021
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