Individual
MR. THOMAS T JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCMT
Contact information
Practice address
113 WILLOW LN, BRISTOL, IL 60512-9711
(630) 553-3015
Mailing address
113 WILLOW LN, BRISTOL, IL 60512-9711
(630) 553-3015
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
IL
Other
Enumeration date
11/06/2006
Last updated
07/08/2007
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