Gomoke, Jacob Avery

Gomoke, Jacob Avery is an individual health care provider with primary practice located at 5818 Harbour View Blvd # D Suite 150, Suffolk VA 23435-3315. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Gomoke, Jacob Avery can be contacted via phone (757) 638-1800.

Contact Information

Primary practice address
5818 Harbour View Blvd # D Suite 150 Suffolk VA 23435-3315
Phone: (757) 638-1800
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2305202181 Virginia

Profile Details

NPI number 1477744373
LBN Legal business name Gomoke, Jacob Avery
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 6th, 2007
Last updated Aug 6th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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