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1760690135
GARY LEONARD JACOBS
BROOKSVILLE, FL
NPI
1760690135
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
156FX1800X Technician/Technologist, Optician
(Licence: FL DO3669)
Enumeration Date
2007-05-18
Last Update Date
2007-07-08
Business Address
-- GARY LEONARD JACOBS OPTICIAN
13132 CORTEZ BLVD
BROOKSVILLE, FL 34613-4858
Phone number: 352-597-0410
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Mailing Address
-- GARY LEONARD JACOBS OPTICIAN
6316 BAYSIDE DR
NEW PORT RICHEY, FL 34652-2038
Phone number: 727-845-8112
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