Individual
BRETT JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-5598
(217) 554-5598
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
056007588
IL
Other
Enumeration date
01/11/2010
Last updated
01/11/2010
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