JACOB J FOUNTAIN

GREENVILLE, SC
NPI1497232565
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: SC  21977)
Enumeration Date2018-07-23
Last Update Date2018-07-23
Business Address
Mr. JACOB J FOUNTAIN FNP
225 ENTERPRISE BLVD SUITE 101
GREENVILLE, SC 29615
Phone number: 864-454-8120
Mailing Address
Mr. JACOB J FOUNTAIN FNP
100 W FARIS RD
GREENVILLE, SC 29605-3002
Phone number: 917-696-6622
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