Individual
MR. THOMAS C JACOBUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC, EMT-B
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
558323
NJ
2255A2300X
Athletic Trainer
25MT00155100
NJ
Other
Enumeration date
12/06/2023
Last updated
12/06/2023
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