Individual
PHILLIP JASON ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
1320 COLLABORATIVE WAY, LEANDER, TX 78641-9081
(125) 701-4805
Mailing address
432 MILLARD ST, GEORGETOWN, TX 78628-2024
(512) 422-3489
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2250
TX
Other
Enumeration date
02/24/2022
Last updated
02/24/2022
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