Individual
JACOB ORNBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4851 GOETHE AVE, SAINT LOUIS, MO 63116-1280
(785) 764-6792
Mailing address
4851 GOETHE AVE, SAINT LOUIS, MO 63116-1280
(785) 764-6792
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2022007009
MO
Other
Enumeration date
11/21/2022
Last updated
11/21/2022
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