Individual
JACOB GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2812 W 12TH AVE, EMPORIA, KS 66801-6202
(620) 208-7878
(620) 208-7000
Mailing address
2812 W 12TH AVE, EMPORIA, KS 66801-6202
(620) 208-7878
(620) 208-7000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11-06806
KS
225100000X
Physical Therapist
T-05515
KS
Other
Enumeration date
05/06/2021
Last updated
09/14/2021
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