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1912562448
IAN TERRELL JACOBS
WHITE PLAINS, NY
NPI
1912562448
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 324906)
Enumeration Date
2019-05-09
Last Update Date
2019-05-09
Business Address
Mr. IAN TERRELL JACOBS LPN
4 GRANADA CRES APT 19
WHITE PLAINS, NY 10603-1237
Phone number: 718-431-5167
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Mailing Address
Mr. IAN TERRELL JACOBS LPN
4 GRANADA CRES APT 19
WHITE PLAINS, NY 10603-1237
Phone number: 718-431-5167
Copy
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