JACOB WAYNE SHAW

ALTON, IL
NPI1558914457
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy174H00000X Health Educator
Enumeration Date2019-07-19
Last Update Date2019-07-19
Business Address
Mr. JACOB WAYNE SHAW A.S, A.A.S, CPT
2603 N RODGERS AVE
ALTON, IL 62002-5524
Phone number: 618-465-3298
Mailing Address
Mr. JACOB WAYNE SHAW A.S, A.A.S, CPT
2603 N RODGERS AVE
ALTON, IL 62002-5524
Phone number: 618-465-3298