Individual
BRADLEY JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
125 BIG SINK RD STE B, VERSAILLES, KY 40383-1956
(859) 879-2090
(859) 879-0363
Mailing address
130 SOUTHERN SCHOOL RD, SOMERSET, KY 42501-3223
(606) 679-4782
(606) 678-5296
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/05/2020
Last updated
08/05/2020
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