Doctor Name: | MR. LEE DUANE JACOBSON |
NPI Number: | 1063418952 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | P.T. |
License Number: | PT11360 |
Business Practice Address: | 20726 W Pennsylvania Ave Dunnellon, FL - 344316717 |
Business Phone Number: | 3524655880 |
Business Fax Number: | 3524655889 |
Mailing Address: | 8455 S Suncoast Blvd, HOMOSASSA |
State: | FL |
Postal Code: | 344465066 |
Phone Number: | 3524655880 |
Fax Number: | 3524655889 |
NPI Enumeration Date: | 06/24/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT11360 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |