Individual
MR. HENRY J.R. JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CSA
Contact information
Practice address
3913 MORTON DR, RICHMOND, VA 23223-1287
(804) 239-8208
Mailing address
3913 MORTON DR, RICHMOND, VA 23223-1287
(804) 239-8208
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3123
VA
Other
Enumeration date
05/05/2006
Last updated
05/06/2010
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