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1720530934
RICHARD ALBERT JACOB
WEST COLUMBIA, SC
NPI
1720530934
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: SC 2671)
Enumeration Date
2016-11-04
Last Update Date
2020-11-06
Business Address
RICHARD ALBERT JACOB PA-C
2728 SUNSET BLVD STE 400
WEST COLUMBIA, SC 29169-4839
Phone number: 803-936-7095
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Mailing Address
RICHARD ALBERT JACOB PA-C
PO BOX 6069
WEST COLUMBIA, SC 29171-6069
Phone number:
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