Individual
JACOB MICKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CSCS, CES
Contact information
Practice address
7 MARSH BROOK DR, SOMERSWORTH, NH 03878-6523
(603) 742-2007
Mailing address
376 HALE ST, BEVERLY, MA 01915-2096
(978) 232-2309
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1526
NH
2255A2300X
Athletic Trainer
3174
MA
Other
Enumeration date
11/08/2016
Last updated
10/06/2023
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