Organization
CLEARALL AIT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT WILLIAM JACOBS JR. (CO-FOUNDER)
(703) 627-0879
Entity
Organization
Contact information
Practice address
5410 RITCHIE HWY STE A, BROOKLYN PARK, MD 21225-3069
(667) 930-5999
Mailing address
PO BOX 46, TERRA CEIA, FL 34250-0046
(667) 930-5999
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
987202700
—
MD
Enumeration date
05/10/2022
Last updated
10/28/2022
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