Search › Illinois › 101YM0800X
Bryan Jacob
NPI 1972663912 · on the registry since 2006 · sole proprietor
Practice
- Address
- 1007 N Main St
Columbia, IL 62236 - Phone
- (618) 281-3100
Registry record
- Primary taxonomy
- 101YM0800X
101YM0800X
- Also registered as
- 101YM0800X
- Licence states on file
- IL, MO
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois