Individual
MR. JACK COONEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
930 COLE ST STE 103, SAN FRANCISCO, CA 94117-4367
(415) 841-2721
Mailing address
114 CLARENDON AVE, SAN FRANCISCO, CA 94114-2104
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
070702863
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070708623
NATABBOC
CA
Enumeration date
10/08/2021
Last updated
10/08/2021
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