Individual
JACEY COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
24 OLD ETNA RD, LEBANON, NH 03766-1937
(603) 442-4207
Mailing address
974 BEAVER MEADOW RD, NORWICH, VT 05055-9460
(802) 369-0089
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0847
NH
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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