Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013444017 |
---|---|
Provider Name | Jacob Patrick Dowling |
First Address | Kalamazoo, MI 49048-2806 |
Second Address | Kalamazoo, MI 49048-2806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2017 |
Last Update Date | 22/05/2017 |