Individual
BRANDY JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 3RD ST, TILLAMOOK, OR 97141-3430
(503) 842-4444
Mailing address
1000 3RD ST, TILLAMOOK, OR 97141-3430
(503) 842-4444
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
61062
OR
Other
Enumeration date
01/04/2016
Last updated
01/04/2016
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