Individual
BRANDON JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 CAMPUS BOX, ELON, NC 27244-2005
(336) 278-6714
Mailing address
2500 CAMPUS BOX, ELON, NC 27244-2005
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-2613
NC
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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