Individual
JACOB ANTHONY MCCUIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5028 SHIPWHEEL DR, STOCKTON, CA 95206-6162
(209) 329-4391
Mailing address
5028 SHIPWHEEL DR, STOCKTON, CA 95206-6162
(209) 329-4391
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
94879
CA
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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