Individual provider · Type 1 NPI

Heidi Sue Jacob, PTA, LMT

Specialist · Stoughton, MA

NPI number 1396092920 Active

Practice location

1519 Central St
Stoughton, MA 02072-4415

Call (781) 297-0979 Map

Fax (781) 297-3703

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000X8676 (MA)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1396092920

Heidi Sue Jacob, PTA, LMT's National Provider Identifier is 1396092920, issued on Aug 14, 2012. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Stoughton, MA. The record was last updated on Aug 16, 2012.