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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JACOB LOUIS DURHAM, PTA

Active Sole Proprietor

JACOB LOUIS DURHAM, PTA is a Occupational Therapist healthcare provider located in JACKSON, Wyoming. NPI 1740024223 is currently active in the NPPES registry. Verify at CMS.

Occupational Therapist · JACKSON, WY

Registration Details

NPI Number
1740024223
Provider Type
Individual
Gender
Male
NPI Issued
Jun 20, 2024 (2.1069043648867 yrs)
Last Updated
Jun 20, 2024
License
PTA1135 (WY)
Sole Proprietor
Yes

Practice Information

Address
555 E BROADWAY AVE STE 100
JACKSON, WY, 830018640
Browse WY providers · Browse ZIP 83001
Phone
3077397491
Primary Specialty
Occupational Therapist
225200000X

Other Occupational Therapist Providers in JACKSON, WY

Name Credential NPI
KATHLEEN L SLADE PTA 1720151285
JARED TRAVIS MARTIN 1942784806
JAMIE LOOMIS 1891270500
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.