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Individual

DR. JACOB IAN SHEPPARD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
701 PLATINUM PT, LAKE MARY, FL 32746-4871
(407) 206-4500
(407) 643-2802
Mailing address
701 PLATINUM PT, LAKE MARY, FL 32746-4871
(407) 206-4500
(407) 643-2802

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT35253
FL
2251X0800X
Orthopedic Physical Therapist
Primary
PT35253
FL

Other

Enumeration date
12/11/2019
Last updated
12/17/2021
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