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 |