Linda Sue Jacques

NPI #1104542125 in Port Henry, New York

Provider Information

NPI Number: 1104542125
Entity Type: Individual
Name: Linda Sue Jacques
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Oct 12, 2022
Last Updated: Oct 12, 2022

Practice Location

Address: 10 ST PATRICK PL
City: Port Henry
State: New York
ZIP Code: 12974-1200
Phone: (518) 546-3355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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