Jacolby Thomas Whitaker

NPI #1164054482 in Alto, Texas

Provider Information

NPI Number: 1164054482
Entity Type: Individual
Name: Jacolby Thomas Whitaker
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Feb 5, 2020
Last Updated: Feb 5, 2020

Practice Location

Address: 8830 STATE HIGHWAY 21
City: Alto
State: Texas
ZIP Code: 75925-6018
Phone: (903) 948-1074

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist/Technologist - Athletic Trainer — Athletic Trainer	2255A2300X
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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