Individual
JACOB KIRKEENG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
724 N MONTEZUMA ST STE A, PRESCOTT, AZ 86301-2066
(928) 925-2871
Mailing address
724 N MONTEZUMA ST STE A, PRESCOTT, AZ 86301-2066
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
04/29/2015
Last updated
03/22/2023
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