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Individual
JACOB MICKEY
Active
Individual
JACOB MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS, CES
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1526
NH
2255A2300X
Athletic Trainer
3174
MA
Other
Enumeration date
11/08/2016
Last updated
10/06/2023
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