Individual
JACOB MATTHEW STEVENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
265 ELM DR, WAYNESBURG, PA 15370-8275
(724) 627-0685
(724) 627-3712
Mailing address
265 ELM DR, WAYNESBURG, PA 15370-8275
(724) 627-0685
(724) 627-3712
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT020874
PA
Other
Enumeration date
08/19/2010
Last updated
08/19/2010
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