Individual
MR. KEVIN JACOB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202-1702
(502) 852-8696
Mailing address
500 S PRESTON ST RM 305, LOUISVILLE, KY 40202-1702
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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