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Individual

JACOB STUMBAUGH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTR

Contact information

Practice address
1200 W HIGHWAY 100, SUITE 9, PORT ISABEL, TX 78578
(956) 607-8329
Mailing address
225 MESQUITE DR, LAGUNA VISTA, TX 78578-2708
(956) 607-8329

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
117104
TX

Other

Enumeration date
03/10/2016
Last updated
03/10/2016
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