MR. Jacob Gerard Vaxmonsky, OTLR

NPI #1255428223 in Port Griffith, Pennsylvania

Provider Information

NPI Number: 1255428223
Entity Type: Individual
Name: MR. Jacob Gerard Vaxmonsky, OTLR
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: OTLR
Enumeration Date: Oct 9, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 1315 MAIN ST
City: Port Griffith
State: Pennsylvania
ZIP Code: 18640-1536
Phone: (570) 655-5697

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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