Individual
NATHAN RICHARD JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-2605
(314) 977-1664
Mailing address
5403 QUENTIN ST, PHILADELPHIA, PA 19128-2818
(314) 606-5522
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/18/2024
Last updated
03/18/2024
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