JACOB L DIDAS

AUGUSTA, GA
NPI1346941051
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NY  F404816-01)
Enumeration Date2023-03-10
Last Update Date2023-03-10
Business Address
JACOB L DIDAS NP
3966 BARRETT ST
AUGUSTA, GA 30909-9554
Phone number: 716-418-2305
Mailing Address
JACOB L DIDAS NP
3966 BARRETT ST
AUGUSTA, GA 30909-9554
Phone number: 716-418-2305
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