| NPI | 1649155698 |
|---|---|
| Other Name | JACOB EGBERT LLC |
| Entity Type | Organization |
| Authorized Contact | JACOB EGBERT Owner 435-938-8657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2025-08-08 |
| Last Update Date | 2025-08-08 |