Individual
JASON JACOBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 N PATTERSON ST, VALDOSTA, GA 31698-0100
(229) 333-5897
Mailing address
1500 N PATTERSON ST, VALDOSTA, GA 31698-0100
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
GA
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
04/23/2019
Last updated
04/23/2019
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