Individual
JACOB WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
580 COMMONWEALTH AVE UNIT 501, BOSTON, MA 02215-2509
(415) 847-7105
Mailing address
580 COMMONWEALTH AVE UNIT 501, BOSTON, MA 02215-2509
(415) 847-7105
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/27/2019
Last updated
01/27/2019
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