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Individual

JACOB ISAAC NESSER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR/L

Contact information

Practice address
700 NE 13TH ST, OKLAHOMA CITY, OK 73104-5004
(572) 522-7959
Mailing address
503 CASA VITA DR, GREENSBURG, PA 15601-8747
(724) 961-4007

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0119009824
VA
225X00000X
Occupational Therapist
Primary
5939
OK
225X00000X
Occupational Therapist
OC019050
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0119009824
VA
05
5939
OK
05
OC019050
PA
Enumeration date
02/13/2023
Last updated
11/20/2024
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