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Organization

PUTNAM DIAGNOSTIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY JACOBSON MD (VP)
(386) 326-1225
Entity
Organization

Contact information

Practice address
6101 CRILL AVE, PALATKA, FL 32177-3875
(386) 326-1225
Mailing address
PO BOX 55, PALATKA, FL 32178-0055

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
800024088
FL

Other

Enumeration date
04/16/2009
Last updated
04/16/2009
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