Individual
CRYSTAL JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
146 GLOVERS CROSS RD, COLERAIN, NC 27924-9444
(252) 287-8718
Mailing address
1265 FAIRWAY TER, ROCKY MOUNT, NC 27804-9619
(252) 287-8717
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
NC
Other
Enumeration date
05/22/2020
Last updated
05/22/2020
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