Individual
JISNA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7015 CARNATION ST, APT# 214, RICHMOND, VA 23225-5294
(804) 272-1927
Mailing address
7015 CARNATION ST, APT# 214, RICHMOND, VA 23225-5294
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305204288
VA
Other
Enumeration date
10/02/2013
Last updated
02/18/2022
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