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General NPI Number Information
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NPI Number | 1548159437
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Entity Type | Organization
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Legal Business Name | JACOBSON PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 07/02/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 3672 AVENSONG VILLAGE CIR
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City | ALPHARETTA
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State | GA
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Zip | 30004-7481
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Country | US
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Telephone | 470-305-3145
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Fax | 470-706-0224
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Provider Business Mailing Address
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Address Line | 3672 AVENSONG VILLAGE CIR
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City | ALPHARETTA
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State | GA
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Zip | 30004-7481
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Country | US
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Telephone | 470-305-3145
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MATTHEW JACOBSON
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Credential | PT, DPT, ATC
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Telephone | 847-525-5888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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