Individual
MARK E. JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
935 MAPLE AVE, LANCASTER, PA 17603-4818
(717) 371-8012
Mailing address
935 MAPLE AVE, LANCASTER, PA 17603-4818
(717) 371-8012
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI002786
PA
Other
Enumeration date
02/17/2012
Last updated
02/17/2012
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