Individual
JACK BIXLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9601 GERMANTOWN AVE, PHILADELPHIA, PA 19118-2693
(484) 667-9540
Mailing address
1317 STONEGATE DR, DOWNINGTOWN, PA 19335-5602
(484) 667-9540
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT007755
PA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
10/02/2019
Last updated
09/23/2021
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