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Contact Information

JACOB DEESE, PT, DPT, ATC
13333 DORMAN RD
PINEVILLE, NC28134-9336
 Phone: 704-716-1024
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2081S0010X 25 Physician/Physical Medicine and Rehabilitation
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for JACOB DEESE · (Male)

NPI Number 1073047759
Status Active
Credentials PT, DPT, ATC
Entity Individual
Enumeration date 04/19/2017
Last updated 02/09/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • NC License # LAT-2888
  • NC License # P20196
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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