Individual
JACOBEY GONZALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3201 N MIDLAND DR STE 130, MIDLAND, TX 79707-0003
(432) 617-3110
Mailing address
2525 N GRANDVIEW AVE STE 400, ODESSA, TX 79761-1621
(432) 617-3110
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4061388
TX
Other
Enumeration date
05/26/2022
Last updated
05/26/2022
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