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Individual

JACOB LAWRENCE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
BS

Contact information

Practice address
1100 7TH AVE, JASPER, AL 35501-4377
(205) 302-9000
Mailing address
1100 7TH AVE, JASPER, AL 35501-4377
(205) 302-9000

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/27/2020
Last updated
05/27/2020
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