Individual
MICHELLE C JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1700 VALLEY WEST DR, WEST DES MOINES, IA 50266-1197
(515) 225-9330
Mailing address
1700 VALLEY WEST DR, WEST DES MOINES, IA 50266-1197
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
23704
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23704
PHARMACIST LICENSE
IA
Enumeration date
09/05/2019
Last updated
12/09/2021
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