Jacob Tyler Depew MS, ATC, LAT, PES

NPI 1033402474 - Specialist/Technologist - 2255A2300X

NPI Details
NPI 1033402474
Gender Male
Enumeration Date 05/18/2011
Last Updated 05/18/2011
Entity Type Individual
Active Over 6 years ago
Practice Location
833 MONTLIEU AVE
HIGH POINT NC, 27262-4221, US
Phone (336) 841-4500
Fax (336) 841-9182
Business Location
833 MONTLIEU AVE
HIGH POINT NC, 27262-4221, US
Phone (336) 841-4500
Fax (336) 841-9182
Toxanomy
Taxonomy Code 2255A2300X
License State North Carolina
License Number 1828
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According to our database, Mr. Jacob Tyler Depew MS, ATC, LAT, PES NPI is 1033402474, taxonomy code is 2255A2300X and license number is 1828, license state is located at North Carolina. Jacob Tyler Depew MS, ATC, LAT, PES physically located at 833 Montlieu Ave, High Point NC, 27262-4221. NPI Number Jacob Tyler Depew MS, ATC, LAT, PES has the Individual type.

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1033402474 NPI number is provided on an as is basis without warranty of any kind. 1033402474 is maintained by the National Plan & Provider Enumeration System. The contents of Jacob Tyler Depew MS, ATC, LAT, PES are for informational purposes only.