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1134842784
JACQUELYN O JACOBS
MISHAWAKA, IN
NPI
1134842784
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
Enumeration Date
2022-09-20
Last Update Date
2022-09-20
Business Address
JACQUELYN O JACOBS
3630 HICKORY RD
MISHAWAKA, IN 46545-8865
Phone number: 574-252-7225
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Mailing Address
JACQUELYN O JACOBS
1609 S 15TH ST
GOSHEN, IN 46526-4558
Phone number:
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