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General NPI Number Information
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NPI Number | 1497265342
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Entity Type | Individual
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Provider Name | DONALD SCOTT JACOBS LMT
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Gender | Male
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Dates
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Enumeration Date | 10/05/2017
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Last Update Date | 05/27/2025
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Provider Practice Location Address
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Address Line | 2240 5TH AVE FL 2
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City | HUNTINGTON
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State | WV
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Zip | 25703-1239
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Country | US
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Telephone | 606-923-1890
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Fax |
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Provider Business Mailing Address
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Address Line | 3112 MASON ST
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City | ASHLAND
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State | KY
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Zip | 41102-5851
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Country | US
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Telephone | 606-923-1890
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175L00000X
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Taxonomy Name | Homeopath
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 2016-3457
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License Number State | WV
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