Irwin, Jacob

Irwin, Jacob is an sole proprietor health care provider with primary practice located at 4343 Shallowford Rd Ste 630 , Marietta GA 30062-5080. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Irwin, Jacob can be contacted via phone (770) 449-5152.

Contact Information

Primary practice address
4343 Shallowford Rd Ste 630 Marietta GA 30062-5080
Phone: (770) 449-5152
Fax: (866) 821-7683
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X GA07576 Georgia

Profile Details

NPI number 1003985797
LBN Legal business name Irwin, Jacob
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 7th, 2006
Last updated Apr 21st, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003985797 NPPES
Georgia Other GA07576 STATE LISC NUMBER

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