Individual
MR. JEFFREY A. JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
400 ROUNDS DR, FENTON, MI 48430-1724
(810) 750-1996
(810) 750-6361
Mailing address
PO BOX 412031, BOSTON, MA 02241-2031
(914) 294-4050
(631) 760-8306
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501006259
MI
Other
Enumeration date
01/23/2008
Last updated
12/04/2024
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