Individual
AUDREY JACOBSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
520 ROSE LN, WICKENBURG, AZ 85390-1447
(928) 684-5529
Mailing address
520 ROSE LN, WICKENBURG, AZ 85390-1447
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12
AZ
Other
Enumeration date
04/05/2018
Last updated
04/05/2018
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