Individual
JACOB FOX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
644 QUILLEN AVE, FOUNTAIN INN, SC 29644-9447
(864) 436-1883
Mailing address
120 SANDY LN, GREENVILLE, SC 29605-5949
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1314
SC
Other
Enumeration date
01/19/2021
Last updated
06/05/2024
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