Individual
MR. JERAD COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
11811 OWENS CANYON LN, CYPRESS, TX 77433-2809
(765) 318-9446
Mailing address
11811 OWENS CANYON LN, CYPRESS, TX 77433-2809
(765) 318-9446
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4674
TX
Other
Enumeration date
04/17/2019
Last updated
04/17/2019
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