Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Louis Durham, PTA

Individual provider Physical Therapy Assistant · NPI 1740024223

Jacob Louis Durham, PTA is a Physical Therapy Assistant in Jackson, Wyoming. Practices as a sole proprietor. Licensed in Wyoming.

Licensed in
WY
In the registry since
2024
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

555 E Broadway Ave Ste 100
Jackson, WY 83001-8640
Phone: (307) 739-7491
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA1135 (WY)

Record details

NPI number1740024223
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorYes
NPI enumeratedJune 20, 2024
Last updated in NPPESJune 20, 2024
Certification dateJune 20, 2024

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