Individual
EMILY KATHLEEN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6535 PAW PAW AVE, COLOMA, MI 49038-8805
(269) 468-3858
Mailing address
07491 COUNTY ROAD 687, SOUTH HAVEN, MI 49090-8143
(269) 767-6037
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302038009
MI
Other
Enumeration date
07/27/2010
Last updated
07/27/2010
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