Jacob Tyre Stancill

NPI #1205399532 in Lagrange, Georgia

Provider Information

NPI Number: 1205399532
Entity Type: Individual
Name: Jacob Tyre Stancill
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Case Management
Enumeration Date: Apr 12, 2019
Last Updated: Apr 12, 2019

Practice Location

Address: 122 GORDON COMMERCIAL DR STE C
City: Lagrange
State: Georgia
ZIP Code: 30240-5754
Phone: (706) 845-4045

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Case Management	251B00000X	Primary

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