Individual
JASON ANTHONY CHARLEBOIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
7607 LA JOLLA BLVD, LA JOLLA, CA 92037-4799
(858) 459-4021
Mailing address
7607 LA JOLLA BLVD, LA JOLLA, CA 92037-4799
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/24/2010
Last updated
02/24/2010
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