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1669177143
JACOB MARK JAMES
GLENDALE, AZ
NPI
1669177143
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-03
Last Update Date
2023-04-03
Business Address
JACOB MARK JAMES DO
18701 N 67TH AVE
GLENDALE, AZ 85308-7100
Phone number: 877-934-9355
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Mailing Address
JACOB MARK JAMES DO
1226 MILLBRIDGE LN
WEST BOUNTIFUL, UT 84087-1418
Phone number: 801-673-7413
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