Individual
DR. JACOB T BARTZ-BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
36 WORKMAN TER, LINCOLN, ME 04457-1162
(207) 794-6025
Mailing address
928 COURTHOUSE RD UNIT 22, GULFPORT, MS 39507-4111
(228) 265-3766
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT5929
ME
Other
Enumeration date
05/14/2021
Last updated
05/14/2021
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