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1114649936
JACOB LANDRAM
ATLANTA, GA
NPI
1114649936
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2022-09-19
Last Update Date
2022-09-19
Business Address
JACOB LANDRAM
4396 BRIARCLIFF RD NE
ATLANTA, GA 30345-2155
Phone number: 256-783-1871
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Mailing Address
JACOB LANDRAM
4396 BRIARCLIFF RD NE
ATLANTA, GA 30345-2155
Phone number: 256-783-1871
Copy
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