Individual
DR. SUSANNA JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
300 COLORADO AVE, PUEBLO, CO 81004-2006
(719) 543-8718
(719) 585-3057
Mailing address
4961 S BEELER ST, GREENWOOD VILLAGE, CO 80111-1311
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD.0000818
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/15/2014
Last updated
07/31/2018
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