Individual
JACOB VERNON WALDECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
14651 HORIZON BLVD, HORIZON CITY, TX 79928-8639
(270) 823-3597
Mailing address
14651 HORIZON BLVD, HORIZON CITY, TX 79928-8639
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT8210
TX
Other
Enumeration date
01/28/2022
Last updated
01/28/2022
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