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Individual

MR. JACOB EVERETT ENGBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.A

Contact information

Practice address
3015 W STOLLEY PARK RD, APT 95, GRAND ISLAND, NE 68801-7238
(402) 984-8614
Mailing address
3015 W STOLLEY PARK RD, APT 95, GRAND ISLAND, NE 68801
(402) 984-8614

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1082
NE

Other

Enumeration date
05/14/2013
Last updated
05/14/2013
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