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Individual

WILLIAM L JACOBSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
2500 WARREN CARROLL DR, RALEIGH, NC 27695-5721
(919) 515-2111
(919) 515-0728
Mailing address
5633 BARHAM CT, RALEIGH, NC 27613-5721
(919) 538-3658

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
LAT-4295
NC

Other

Enumeration date
01/09/2019
Last updated
12/12/2019
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