Individual
REBECCA LYNN JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
7150 BROCKTON AVE, RIVERSIDE, CA 92506-2614
(951) 683-6370
Mailing address
12025 SILICON AVE, CHINO, CA 91710-1669
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/27/2025
Last updated
02/27/2025
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