Individual
JEDIDIAH ANDREW JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO03265
CA
224P00000X
Prosthetist
CPO03265
CA
Other
Enumeration date
12/27/2017
Last updated
03/17/2018
Update your record
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