Individual
DR. RYAN BLAINE JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
200 HAWKINS DR, CC101 GH PHARMACY, IOWA CITY, IA 52242-1009
(319) 356-2577
Mailing address
90 ANDREA CT, IOWA CITY, IA 52246-4189
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19711
IA
Other
Enumeration date
01/29/2007
Last updated
07/08/2007
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