Individual
SHANNON JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3250 W 66TH ST UNIT 55, EDINA, MN 55435-2522
(651) 447-6737
Mailing address
8063 N ARCATA DR, TUCSON, AZ 85743-1182
(423) 914-0434
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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