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Individual

MR. JACOB LEE WALDRON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7555 N PIMA RD, SCOTTSDALE, AZ 85258-4013
(815) 514-0723
Mailing address
3220 N 38TH ST UNIT 7, PHOENIX, AZ 85018-6306
(815) 514-0723

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary

Other

Enumeration date
10/06/2014
Last updated
06/11/2022
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