Doctor Name: | GRANT JACOBSON |
NPI Number: | 1134510647 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | 076382 |
Business Practice Address: | 5627 Nw 86th St Suite 200 Johnston, IA - 501311738 |
Business Phone Number: | 5152700303 |
Business Fax Number: | 5152700160 |
Mailing Address: | 5627 Nw 86th St, Suite 200 JOHNSTON |
State: | IA |
Postal Code: | 501311738 |
Phone Number: | 5152700303 |
Fax Number: | 5152700160 |
NPI Enumeration Date: | 02/05/2015 |
NPI Last Update Date: | 02/05/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 076382 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IA |
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 |