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Individual

JACY JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2740 SOUTH AVE W STE 101, MISSOULA, MT 59804-5137
(406) 543-0617
Mailing address
2600 PEREGRINE LOOP, MISSOULA, MT 59808-5814

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
30349
MT

Other

Enumeration date
02/10/2025
Last updated
10/22/2025
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