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1164916839
JACOB LUCAS BROADHURST
JACKSONVILLE, FL
NPI
1164916839
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: FL 30341)
Enumeration Date
2018-06-18
Last Update Date
2018-06-18
Business Address
JACOB LUCAS BROADHURST PT, DPT
3311 BEACH BLVD
JACKSONVILLE, FL 32207-3704
Phone number: 352-246-7339
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Mailing Address
JACOB LUCAS BROADHURST PT, DPT
8842 NATURE VIEW LN W
JACKSONVILLE, FL 32217-9327
Phone number: 352-246-7339
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