Individual
JACKLYN SUE BASCOMB-HARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
400 BIZZELL ST, COLLEGE STATION, TX 77843-0002
(979) 458-0257
Mailing address
984 RICE DR, BRYAN, TX 77803-1867
(970) 301-7183
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/09/2017
Last updated
01/25/2023
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