Individual
JACOB MIDDLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13609 CALIFORNIA ST STE 200, OMAHA, NE 68154-5245
(402) 891-1118
Mailing address
13609 CALIFORNIA ST STE 200, OMAHA, NE 68154-5245
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02914
KS
225200000X
Physical Therapy Assistant
A-1177
NM
Other
Enumeration date
10/12/2015
Last updated
10/12/2015
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