Individual
JACOB BRANHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1390 BOONE AVENUE EXT STE 23, KINGSLAND, GA 31548-6516
(912) 319-0400
Mailing address
1390 BOONE AVENUE EXT STE 23, KINGSLAND, GA 31548-6516
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP053576T
GA
225100000X
Physical Therapist
PT022198
OH
Other
Enumeration date
02/17/2026
Last updated
02/18/2026
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