Provider Demographics
NPI:1649041864
Name:SAUNDERS, JACOB (PTA)
Entity type:Individual
Prefix:MR
First Name:JACOB
Middle Name:
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 EDINBURGH CT
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-9045
Mailing Address - Country:US
Mailing Address - Phone:336-420-4262
Mailing Address - Fax:
Practice Address - Street 1:1315 GREENSBORO RD
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27260-2611
Practice Address - Country:US
Practice Address - Phone:336-821-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA8320225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant