Individual
LAURA L JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1288 SW SIMPSON AVE, SUITE F, BEND, OR 97702-3195
(541) 312-2004
Mailing address
1333 NW CUMBERLAND AVE, UNIT B, BEND, OR 97701-3116
(717) 433-0806
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60407
OR
225100000X
Physical Therapist
PT021614
PA
Other
Enumeration date
12/09/2011
Last updated
08/19/2015
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