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Individual

SCOTT DOMINICK JACOBS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
200 HENRY CLAY AVE, NEW ORLEANS, LA 70118-5720
(985) 507-0273
Mailing address
285 E MCCLELLAN ST, PONCHATOULA, LA 70454-2843
(985) 507-0273

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
337148
LA

Other

Enumeration date
06/20/2023
Last updated
06/20/2023
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