Individual
JACOB BOOTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3000 GOFFS FALLS RD, SUITE 101, MANCHESTER, NH 03111-1000
(800) 995-2673
Mailing address
3000 GOFFS FALLS RD, SUITE 101, MANCHESTER, NH 03111-1000
(800) 995-2673
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
16303
CA
225X00000X
Occupational Therapist
5698-26
WI
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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