Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports |
NPI | 1346249398 |
---|---|
Provider Name | Gerald E Jacobi |
First Address | Omaha, NE 68154-2612 |
Second Address | Omaha, NE 68154-2612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 08/07/2007 |