Individual
CHARLA JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
148 S 39TH ST, OMAHA, NE 68131-3002
(402) 708-3029
Mailing address
148 S 39TH ST, OMAHA, NE 68131-3002
(402) 708-3029
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3368
NE
Other
Enumeration date
06/02/2016
Last updated
06/02/2016
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