Individual
DR. TRAVIS DAVID JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
901 MACARTHUR BLVD, MUNSTER, IN 46321
(219) 836-1600
Mailing address
911 S MAIN ST, CENTERVILLE, OH 45458-5801
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH. 03234093
OH
Other
Enumeration date
07/14/2014
Last updated
06/13/2018
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