Individual
TERRIE S JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
101527
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
670001949
RAILROAD MEDICARE
MN
05
—
995405200
—
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
SD
05
—
ENROLLED
—
WI
Enumeration date
02/10/2006
Last updated
12/05/2012
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