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Individual

MR. JACOB GARVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ATC

Contact information

Practice address
39 W. BANKVIEW DR., FRANKFORT, IL 60423
(815) 464-7113
Mailing address
910 W 19TH PL, BSMT, CHICAGO, IL 60608-3426

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
002488
NY
246Z00000X
Other Specialist/Technologist
Primary
003962
IL

Other

Enumeration date
03/24/2014
Last updated
06/18/2015
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