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MR. LAWRENCE JASON JACOBS SFIDC

Independent Duty Corpsman >> Military Health Care Provider >> Other Service Providers

Registrant NPI Number: 1003243338

Individual Registrant:
MR. LAWRENCE JASON JACOBS SFIDC
Gender: M
Not Sole Proprietor

Location and contact information for practice:
34949 VISCARIA CT  WINCHESTER, CA 92596-8968 US
Tel: 260-740-6714  Fax: --

Contact information for business:
34949 VISCARIA CT  WINCHESTER, CA 92596-8968 US
Tel: 260-740-6714  Fax: --

Registration Information:
NPI: 1003243338
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1710I1002XOther Service Providers
Military Health Care Provider
Independent Duty Corpsman

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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