Individual
JACOB FAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MED, LAT
Contact information
Practice address
201 SPRING BOUQUET ST, STEPHENVILLE, TX 76401-1810
(817) 308-2955
Mailing address
201 SPRING BOUQUET ST, STEPHENVILLE, TX 76401-1810
(817) 308-2955
(254) 968-9673
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT4205
TX
Other
Enumeration date
04/18/2014
Last updated
04/18/2014
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