Individual
JACOB THOMAS WHITACRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
8400 DEBOLD KOEBEL RD, MORROW, OH 45152-8333
(513) 532-8581
Mailing address
8400 DEBOLD KOEBEL RD, MORROW, OH 45152-8333
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1822
KY
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/08/2018
Last updated
01/30/2024
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