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Individual

JACOB MICHAEL LANDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1001 VAN BUREN AVE STE 3, INDIAN TRAIL, NC 28079-5541
(704) 628-6053
(704) 628-6702
Mailing address
1429 BRYANT ST STE A, CHARLOTTE, NC 28208-5201
(704) 919-0867
(704) 817-8579

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P24828
NC
225100000X
Physical Therapist
Primary

Other

Enumeration date
03/21/2026
Last updated
04/16/2026
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