Individual
JACOB TERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6403 N PROSPECT AVE # 450, GLADSTONE, MO 64119-1545
(816) 683-8618
Mailing address
2122 YORK RD STE 300, OAK BROOK, IL 60523-1925
(630) 575-1980
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
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