Individual
JACOB BRANDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.A.T.
Contact information
Practice address
2237 S JACKSON ST, SAN ANGELO, TX 76904-5131
(325) 481-2257
Mailing address
4450 SUNSET DR, SAN ANGELO, TX 76901-5611
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4889
TX
Other
Enumeration date
01/06/2017
Last updated
01/22/2021
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