Individual
MR. WILLIAM JOHN JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
855 MANKATO AVE, WINONA, MN 55987-4868
(507) 429-2483
Mailing address
359 E LAKE BLVD, WINONA, MN 55987-5314
(507) 429-2483
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1153
MN
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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