Individual
KARA JEAN JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T. MLD/CDT
Contact information
Practice address
36 CHICKERING DR UNIT 106, BRATTLEBORO, VT 05301-4419
(802) 258-2337
(802) 258-2307
Mailing address
36 CHICKERING DR UNIT 106, BRATTLEBORO, VT 05301-4419
(802) 258-2337
(802) 258-2307
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10720
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0399132
—
MA
01
—
1294632
FALLON
MA
01
—
468310
TUFTS
MA
01
—
Y68357
BCBS
MA
Enumeration date
08/29/2006
Last updated
08/31/2020
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