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Individual

BRENDAN JACOB

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
202 JANET YULMAN WAY, NEW ORLEANS, LA 70118-5671
(504) 864-1476
(504) 864-9914
Mailing address
202 MCALISTER EXTENSION, NEW ORLEANS, LA 70118
(504) 864-1476
(504) 864-9914

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
303137
LA

Other

Enumeration date
01/26/2017
Last updated
01/26/2017
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