Individual
MS. CHARLENE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
320 WILLIAMS BLVD, KENNER, LA 70062-7630
(504) 416-1840
Mailing address
1017 KINLER ST, LULING, LA 70070-4533
(504) 416-1840
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
441590119
LA
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Enumeration date
05/16/2022
Last updated
12/04/2024
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