Individual
MR. JACOB DAVID IBEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
3 WEYMOUTH RD, ENFIELD, CT 06082
(860) 763-7625
(860) 272-2912
Mailing address
58 GIDDINGS AVE, WINDSOR, CT 06095-3702
(860) 687-1459
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
000021
CT
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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