Individual
RALPH JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
10261 PINES BLVD, PEMBROKE PINES, FL 33026-6008
(954) 356-2878
Mailing address
10261 PINES BLVD, PEMBROKE PINES, FL 33026-6008
(287) 895-4356
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
13233
FL
Other
Enumeration date
10/12/2018
Last updated
10/12/2018
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