Individual
JAKE EVERETT BACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RVT
Contact information
Practice address
415 W LYNWOOD AVE APT 2, SAN ANTONIO, TX 78212-2239
(541) 680-2858
Mailing address
415 W LYNWOOD AVE APT 2, SAN ANTONIO, TX 78212-2239
(541) 680-2858
Taxonomy
Speciality
Code
Description
License number
State
2471V0105X
Vascular Sonography Radiologic Technologist
Primary
193402
OR
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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