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1760672364
ALFONZO L JACOBS
WILDWOOD, FL
NPI
1760672364
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2007-07-30
Last Update Date
2007-07-30
Business Address
Mr. ALFONZO L JACOBS SFIDC
707 MOSS ST
WILDWOOD, FL 34785-0932
Phone number: 228-246-9613
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Mailing Address
Mr. ALFONZO L JACOBS SFIDC
PO BOX 932 707 MOSS ST
WILDWOOD, FL 34785-0932
Phone number: 228-246-9613
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