Individual
MADELEINE JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
9201 S I 35 SERVICE RD, MOORE, OK 73160-9046
(405) 609-7005
Mailing address
2938 CARLTON WAY, OKLAHOMA CITY, OK 73120-2001
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
5996
OK
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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