Individual
MARSHALL L JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
12010 PACIFIC ST, OMAHA, NE 68154
(402) 778-1100
Mailing address
12010 PACIFIC ST, OMAHA, NE 68154
(402) 778-1100
(402) 778-1200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1190
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9823
BLUE CROSS BLUE SHIELD
NE
Enumeration date
06/20/2006
Last updated
07/08/2007
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