Individual
JACOB ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
421 N MAIN ST, LEEDS, MA 01053-9764
(413) 584-4040
Mailing address
421 N MAIN ST, LEEDS, MA 01053-9764
(661) 992-8452
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12860
CT
225100000X
Physical Therapist
Primary
23073
MA
Other
Enumeration date
10/04/2017
Last updated
05/19/2023
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