Individual
JACOB DAVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.M.T.
Contact information
Practice address
322 W 3RD ST, SUITE B, CARROLL, IA 51401-2708
(712) 775-2418
Mailing address
2329 YANKEE AVE, LYTTON, IA 50561-7587
(712) 210-1649
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
005997
IA
Other
Enumeration date
03/18/2014
Last updated
03/18/2014
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