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General NPI Number Information
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NPI Number | 1619789864
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Entity Type | Individual
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Provider Name | JACOB MARSH DC
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Gender | Male
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 317 W 11TH ST
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City | KEARNEY
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State | NE
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Zip | 68845-7331
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Country | US
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Telephone | 308-999-0745
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Fax |
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Provider Business Mailing Address
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Address Line | 73618 W RD
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City | FUNK
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State | NE
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Zip | 68940-4016
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Country | US
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Telephone | 308-455-0840
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2209
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License Number State | NE
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