Doctor Name: | MRS. SANDRA LEE JACOBS |
NPI Number: | 1659672046 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PT |
License Number: | 5501004822 |
Business Practice Address: | 606 Lake St Roscommon, MI - 486537615 |
Business Phone Number: | 9892759955 |
Business Fax Number: | 9892759955 |
Mailing Address: | 1480 West Federal Highway, ROSCOMMON |
State: | MI |
Postal Code: | 48653 |
Phone Number: | 9892759100 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2010 |
NPI Last Update Date: | 11/16/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501004822 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |