DERIC L JACOBS

PORT ORANGE, FL
NPI1568679876
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy111N00000X Chiropractor
(Licence: FL  ch8698)
Enumeration Date2007-05-17
Last Update Date2010-01-14
Business Address
-- DERIC L JACOBS DC
4536 S. CLYDE MORRIS BLVD. SUITE 3
PORT ORANGE, FL 32129-4017
Phone number: 386-562-4099
Mailing Address
-- DERIC L JACOBS DC
3625 SCOTT ST
PORT ORANGE, FL 32129-4225
Phone number: 386-562-4099
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