Individual
JESSICA DAWN JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 MCKINLEY AVE, HARRISVILLE, WV 26362-1150
(304) 643-2712
Mailing address
3331 PIKE RD, ELLENBORO, WV 26346-6754
(304) 481-8777
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002111
WV
Other
Enumeration date
10/23/2023
Last updated
10/23/2023
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