Provider Demographics
NPI:1215383831
Name:JACOBS, CHRISTIAN (LAC)
Entity type:Individual
Prefix:MR
First Name:CHRISTIAN
Middle Name:
Last Name:JACOBS
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 GREEN OAK RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28804-3003
Mailing Address - Country:US
Mailing Address - Phone:828-680-0326
Mailing Address - Fax:
Practice Address - Street 1:378 HAYWOOD RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-4232
Practice Address - Country:US
Practice Address - Phone:828-680-0326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-12
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC701171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist