Individual
VIVIAN A. CLARK-JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8300 HOUGH AVENUE, CLEVELAND, OH 44103
(216) 231-7700
(216) 231-7920
Mailing address
8300 HOUGH AVENUE, CLEVELAND, OH 44103
(216) 231-7700
(216) 231-7920
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50000747
OH
Other
Enumeration date
10/03/2006
Last updated
02/15/2008
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