Individual
JACOB RILEY CALLAHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, CES
Contact information
Practice address
5302 55TH ST, SAN DIEGO, CA 92182-0001
(619) 594-5272
Mailing address
3046 MISSION VILLAGE DR, SAN DIEGO, CA 92123-3214
(619) 846-0428
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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