Individual
JACOB WAYNE OSWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4790 BARKLEY CIR STE A, FORT MYERS, FL 33907-7593
(239) 275-8882
Mailing address
9851 DECORUM DR APT 215, FORT MYERS, FL 33966-6565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1205782
—
Other
Enumeration date
04/05/2023
Last updated
08/01/2023
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