Individual
JACOB JULIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 DECATUR ST SE, ATLANTA, GA 30303-3204
(716) 984-8068
Mailing address
140 DECATUR ST SE, ATLANTA, GA 30303-3204
(716) 984-8068
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/08/2021
Last updated
09/08/2021
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