Individual
JACOB JOSIAH STOCKLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
2237 S. JACKSON, SAN ANGELO, TX 76904
(325) 481-2036
Mailing address
2504 SWEETBRIAR DR APT 402, SAN ANGELO, TX 76904-6728
(254) 251-7959
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7892
TX
Other
Enumeration date
06/11/2019
Last updated
06/11/2019
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