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Individual

JASON DAVID HEROLD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1445 295TH AVE, FORT ATKINSON, IA 52144-7448
(563) 412-9928
Mailing address
1445 295TH AVE, FORT ATKINSON, IA 52144-7448
(563) 412-9928

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
132981
IA

Other

Enumeration date
08/09/2023
Last updated
05/28/2025
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