Individual
JACOB L MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
200 S BROADWAY, GREEN BAY, WI 54303-1516
(920) 448-2000
Mailing address
200 S BROADWAY, GREEN BAY, WI 54303-1516
(920) 448-2000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1590068620
WI
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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