Most Relevant Information
Provider Data
| NPI Number: | 1003488446 |
| Provider Name: | JACOB DANIEL O'NEILL |
| Entity Type: | Individual |
| Taxonomy Code: | 225200000X |
| Specialty: | Physical Therapy Assistant |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/14/2021 |
| Last Updated: | 07/14/2021 |
Provider Practice Location
20800 W MAPLE RD
ELKHORN
NE
680225108
Practice Location Phone/Fax
| Phone: | 8667483655 |
| Fax: |
Provider Mailing Location
2671 N 97TH ST
OMAHA
NE
681345368
Provider Mailing Phone/Fax
| Phone: | 4027145621 |
| Fax: |