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Individual

DR. JACOB CLIFFORD TYSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT

Contact information

Practice address
3500 WESTGATE DR STE 504, DURHAM, NC 27707-2568
(919) 489-8809
Mailing address
1401 N FORK RD, BLACK MOUNTAIN, NC 28711-2513
(919) 951-8457

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19758
NC

Other

Enumeration date
11/09/2020
Last updated
12/15/2025
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