Individual
JACOB BAMFORD COBLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
40 WRIGHT ST, PALMER, MA 01069-1138
(413) 370-5400
(413) 370-5654
Mailing address
280 CHESTNUT ST FL 2, SPRINGFIELD, MA 01199-1001
(413) 794-5700
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA8016
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/23/2020
Last updated
08/30/2021
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