Individual
JACOB D JELMINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
720 SPORTS CENTER DRIVE, LEXINGTON, KY 40506-0001
(310) 426-0188
Mailing address
120 E MAIN ST APT 901, LEXINGTON, KY 40507-1333
(310) 426-0188
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000035130
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/18/2018
Last updated
08/11/2020
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