Individual
MS. MARY E JACOBS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
4201 S WASHINGTON ST, MARION, IN 46953-4974
(765) 677-1675
(765) 677-1676
Mailing address
1715 W OVERLOOK RD, MARION, IN 46952-1120
(765) 677-1675
(765) 677-1676
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
36000359A
IN
Other
Enumeration date
09/09/2005
Last updated
07/08/2007
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