Individual
MR. JACOB LEE BEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Contact information
Practice address
6820 EL DORADO DR, PRESCOTT, AZ 86303
(928) 308-3462
Mailing address
6820 EL DORADO DR, PRESCOTT, AZ 86303-6526
(928) 308-3462
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-009376
AZ
Other
Enumeration date
03/14/2009
Last updated
12/25/2018
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