MR. Michael Ivan Jacoby

NPI #1548553167 in Dalton, Pennsylvania

Provider Information

NPI Number: 1548553167
Entity Type: Individual
Name: MR. Michael Ivan Jacoby
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Enumeration Date: May 16, 2011
Last Updated: May 16, 2011

Practice Location

Address: 192 LOCUST LN
City: Dalton
State: Pennsylvania
ZIP Code: 18414-9557
Phone: (570) 563-3304

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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