Individual
JACOB GORHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD, LD, NASM-CPT
Contact information
Practice address
424 W AARON DR, STATE COLLEGE, PA 16803-3043
(814) 234-1625
Mailing address
1000 W AARON DR APT H07, STATE COLLEGE, PA 16803-3151
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/27/2024
Last updated
08/27/2024
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