Individual
AMY ANNA JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
27672 ONION HOLLOW LANE, LONE ROCK, WI 53556-9002
(608) 475-9151
Mailing address
27672 ONION HOLLOW LN, LONE ROCK, WI 53556-9002
(608) 475-9151
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
899027
WI
Other
Enumeration date
05/23/2008
Last updated
05/23/2008
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