Jacob Allen Burgoon

NPI #1437779212 in Circle Pines, Minnesota

Provider Information

NPI Number: 1437779212
Entity Type: Individual
Name: Jacob Allen Burgoon
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Apr 21, 2020
Last Updated: Apr 21, 2020

Practice Location

Address: 310 LITTLE JOHN DR
City: Circle Pines
State: Minnesota
ZIP Code: 55014-1721
Phone: (360) 223-9941

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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