NPI 1053132928

Henry William Jacobs, BSBAMSATSTUDENT

Practitioner Athletic Trainer Madison, WI

Practice location

Address: 1475 Engineering Dr, Madison, WI 53706-1607
Phone: (608) 264-8065
Mailing address: 5673 Cheryl Dr, Fitchburg, WI 53711-5371

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X

Other Specialist/Technologist providers in Wisconsin →

Registry record

NPI: 1053132928
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Oct 2024
Record last updated: 23 Oct 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.