Individual
JACOB PETER WOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
314 HIGHWAY 90 STE 102, WAVELAND, MS 39576-2673
(228) 304-1209
Mailing address
745 KALEKI WAY, DIAMONDHEAD, MS 39525-4075
(228) 304-1209
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2885
MS
Other
Enumeration date
07/30/2024
Last updated
07/30/2024
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