Individual
JACOB NORTHCUTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
802 S JOHNSON ST, ALVIN, TX 77511-3300
(281) 967-9046
Mailing address
802 S JOHNSON ST, ALVIN, TX 77511-3300
(281) 967-9046
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7179
TX
Other
Enumeration date
10/16/2017
Last updated
10/16/2017
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