JACOB MEDFORD

TEMPE, AZ
NPI1497415475
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Enumeration Date2021-12-18
Last Update Date2021-12-18
Business Address
JACOB MEDFORD
1204 E BASELINE RD STE 205
TEMPE, AZ 85283-1453
Phone number: 619-708-1440
Mailing Address
JACOB MEDFORD
44276 W NEELY DR
MARICOPA, AZ 85138-9427
Phone number: 619-708-1440