Individual
JACOB STEPHEN PAVOLIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1109 S SCHUMAKER DR, SALISBURY, MD 21804-9256
(443) 397-5375
Mailing address
1109 S SCHUMAKER DR, SALISBURY, MD 21804-9256
(443) 397-5375
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A-4995
MD
Other
Enumeration date
02/22/2021
Last updated
02/22/2021
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