Individual
JACOB SAMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5641 CRAWFORDSVILLE RD, INDIANAPOLIS, IN 46224-3718
(317) 524-8570
Mailing address
9082 E US HIGHWAY 36, AVON, IN 46123-7780
(131) 752-4857
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05015279A
IN
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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