Individual
MATTHEW JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.D.
Contact information
Practice address
921 NE 13TH ST, 120, OKLAHOMA CITY, OK 73104-5007
(405) 456-3750
Mailing address
921 NE 13TH ST, 120, OKLAHOMA CITY, OK 73104-5007
(405) 456-3750
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1562
OK
Other
Enumeration date
02/11/2011
Last updated
02/11/2011
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