Jacob David Ibey, ATC Valid NPI

Individual provider · Athletic Trainer · Enfield, CT

NPI

1124123872

Type

Individual (Type 1)

Primary specialty

Athletic Trainer (Specialist/Technologist)

Specialty group

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy code

2255A2300X

License number

000021 (CT)

Sex

Male

Sole proprietor

Yes

Enumerated

2006-09-14

Last updated

2007-07-08