Individual
JASON WENTWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, CSCS
Contact information
Practice address
40 ALLEN ST, BROCKPORT, NY 14420
(585) 637-5303
Mailing address
40 ALLEN ST, BROCKPORT, NY 14420-2228
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/01/2018
Last updated
02/01/2018
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