Individual
CLARISSA LYNN JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
8301 TALBOT PL, JOHNSTON, IA 50131-8761
(515) 278-2625
Mailing address
6500 CORPORATE DRIVE, JOHNSTON, IA 50131-8761
(515) 270-9030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
01457
IA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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