Individual
AMANDA MARIE JACOBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1615 STANLEY ST, NEW BRITAIN, CT 06050-2439
(860) 832-2300
Mailing address
41 KINGWOOD PL, NEW BRITAIN, CT 06053-1733
(860) 938-5602
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
06/04/2024
Last updated
06/04/2024
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