Derek Mitchell Jambon

NPI #1093217457 in Covington, Louisiana

Provider Information

NPI Number: 1093217457
Entity Type: Individual
Name: Derek Mitchell Jambon
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Mar 1, 2018
Last Updated: Mar 1, 2018

Practice Location

Address: 330 FALCONER DR STE D
City: Covington
State: Louisiana
ZIP Code: 70433-8211
Phone: (985) 900-2305

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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