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1497415475
JACOB MEDFORD
TEMPE, AZ
NPI
1497415475
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Enumeration Date
2021-12-18
Last Update Date
2021-12-18
Business Address
JACOB MEDFORD
1204 E BASELINE RD STE 205
TEMPE, AZ 85283-1453
Phone number: 619-708-1440
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Mailing Address
JACOB MEDFORD
44276 W NEELY DR
MARICOPA, AZ 85138-9427
Phone number: 619-708-1440
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