JACOB LOUIS DURHAM

JACKSON, WY
NPI1740024223
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WY  PTA1135)
Enumeration Date2024-06-20
Last Update Date2024-06-20
Business Address
JACOB LOUIS DURHAM PTA
555 E BROADWAY AVE STE 100
JACKSON, WY 83001-8640
Phone number: 307-739-7491
Mailing Address
JACOB LOUIS DURHAM PTA
555 E BROADWAY AVE STE 100
JACKSON, WY 83001-8640
Phone number: 307-739-7491
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