Individual
TIMOTHY JACQUES
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
760 COOPER ST, AGAWAM, MA 01001-2177
(413) 246-2271
Mailing address
490 N WEST ST, FEEDING HILLS, MA 01030-1029
(413) 789-1851
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
MA
Other
Enumeration date
05/11/2006
Last updated
07/08/2007
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