Individual
MS. NIRUPAMA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, CWS
Contact information
Practice address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3656
Mailing address
2401 W UNIVERSITY AVE, MUNCIE, IN 47303-3428
(765) 747-3656
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004082A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200332623
TAX ID
IN
Enumeration date
11/16/2005
Last updated
12/02/2009
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