Individual
JACOB ALEXANDER GOOLSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
X
Contact information
Practice address
10412 WASHINGTON HWY # A, GLEN ALLEN, VA 23059-1918
(804) 653-4102
Mailing address
10412 WASHINGTON HWY # A, GLEN ALLEN, VA 23059-1918
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
Other
Enumeration date
07/02/2025
Last updated
07/02/2025
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