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Individual

JACOB RYAN ARCHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
EMT

Contact information

Practice address
1607 E PALMDALE BLVD STE D, PALMDALE, CA 93550-4880
(310) 728-9089
Mailing address
1607 E PALMDALE BLVD STE D, PALMDALE, CA 93550-4880
(310) 728-9089

Taxonomy

Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
E120142
CA

Other

Enumeration date
05/11/2021
Last updated
05/11/2021
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