JARED A DESTACKELBERG

OCALA, FL
NPI1104136399
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: FL  PAT 9105672)
Enumeration Date2010-10-21
Last Update Date2010-10-21
Business Address
-- JARED A DESTACKELBERG PA
1901 SE 18TH AVE STE 101
OCALA, FL 34471-8215
Phone number: 352-622-3360
Mailing Address
-- JARED A DESTACKELBERG PA
1901 SE 18TH AVE STE 101
OCALA, FL 34471-8215
Phone number: 352-622-3360
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