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Individual

MR. JACOB NORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MAT, A.T.C.

Contact information

Practice address
307 RAILROAD ST., ANTWERP, OH 45813
(419) 672-8388
Mailing address
307 RAILROAD ST., P.O. BOX 197, ANTWERP, OH 45813
(419) 672-8388

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT 003648
OH

Other

Enumeration date
12/02/2011
Last updated
12/02/2011
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