Richard Dean Jacobs, PT

NPI #1851544290 in Moose Lake, Minnesota

Provider Information

NPI Number: 1851544290
Entity Type: Individual
Name: Richard Dean Jacobs, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Oct 29, 2008
Last Updated: Oct 29, 2008

Practice Location

Address: 710 S KENWOOD AVE
City: Moose Lake
State: Minnesota
ZIP Code: 55767-9405
Phone: (218) 485-5634

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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