Provider Demographics
NPI:1043086069
Name:JACOBS, DAKOTA JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:DAKOTA
Middle Name:JAMES
Last Name:JACOBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4481 TOWNSHIP ROAD 367
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44654-8885
Mailing Address - Country:US
Mailing Address - Phone:740-507-4744
Mailing Address - Fax:
Practice Address - Street 1:4481 TOWNSHIP ROAD 367
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:OH
Practice Address - Zip Code:44654-8885
Practice Address - Country:US
Practice Address - Phone:740-507-4744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHDC-05215111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor