Individual
THRESIAMMA JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
142 E MAUMEE ST, ADRIAN, MI 49221-2735
(517) 263-5810
Mailing address
2757 BYRNWYCK W, MAUMEE, OH 43537-9720
(419) 865-2523
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
TJ048425
MI
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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