Individual
JILLAIN ALYCE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2038 LEE ROAD 137, LOT 326, AUBURN, AL 36832-7510
(334) 885-0980
Mailing address
12515 COUNTY ROAD 87, WOODLAND, AL 36280-6505
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
S10765
AL
Other
Enumeration date
03/31/2015
Last updated
03/31/2015
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