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General NPI Number Information
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NPI Number | 1639506710
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Entity Type | Individual
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Provider Name | JACOB WOLF N.D., L.AC., DIPL.OM
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Gender | Male
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Dates
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Enumeration Date | 10/03/2013
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Last Update Date | 02/20/2018
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Provider Practice Location Address
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Address Line | 8655 MARKET ST
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City | MENTOR
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State | OH
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Zip | 44060-4170
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Country | US
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Telephone | 440-255-5508
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Fax |
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Provider Business Mailing Address
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Address Line | 32300 TRACY LN
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City | SOLON
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State | OH
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Zip | 44139-2010
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Country | US
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Telephone | 215-208-6114
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 66.000031
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 13-1376
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License Number State | AZ
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