JACOB LOUIS DURHAM PTA
Individual Provider (NPI-1)
Active
Physical Therapy Assistant
Provider Information
- NPI Number
1740024223- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PTA
- Status
- Active
Contact & Location
- Address
- 555 E BROADWAY AVE STE 100, JACKSON, WY, 830018640
- Phone
- (307) 739-7491
Specialties & Taxonomies
Physical Therapy Assistant
Primary License: WY #PTA1135