Provider Demographics
NPI:1679636104
Name:JACOBS, WENDY JOY (DC)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:JOY
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 26TH RD S
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22206-2818
Mailing Address - Country:US
Mailing Address - Phone:703-486-2225
Mailing Address - Fax:703-486-0520
Practice Address - Street 1:2420 26TH RD S
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22206-2818
Practice Address - Country:US
Practice Address - Phone:703-486-2225
Practice Address - Fax:703-486-0520
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104556185111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician