Individual
MELISSA JACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DAT, LAT, ATC
Contact information
Practice address
15826 ROXTON RIDGE DR, WEBSTER, TX 77598-2544
(484) 515-5728
Mailing address
15826 ROXTON RIDGE DR, WEBSTER, TX 77598-2544
(484) 515-5728
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
03/06/2013
Last updated
07/30/2020
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