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1982383295
JACOB J GOTHAM
OGDENSBURG, NY
NPI
1982383295
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2023-07-13
Last Update Date
2023-07-13
Business Address
JACOB J GOTHAM
1003 PARK ST
OGDENSBURG, NY 13669-3911
Phone number: 315-713-9090
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Mailing Address
JACOB J GOTHAM
1003 PARK ST
OGDENSBURG, NY 13669-3911
Phone number: 315-713-9090
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