| NPI | 1760555288 |
|---|---|
| Former Legal Business Name | JEFFREY T. JACOBS |
| Entity Type | Organization |
| Authorized Contact | JEFFREY THOMAS JACOBS Owner 208-386-3338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 222Z00000X Orthotist |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2009-02-24 |