Individual
BRIAN M JAGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AT, ATC
Contact information
Practice address
350 LAFAYETTE AVE SE, GRAND RAPIDS, MI 49503-4656
(616) 456-8515
Mailing address
1148 W ADDISON ST APT 1, CHICAGO, IL 60613-3806
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096003085
IL
2255A2300X
Athletic Trainer
Primary
2601001294
MI
Other
Enumeration date
11/07/2011
Last updated
03/19/2018
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