NPI 1619910742

Jesse D Irwin, ATC

Practitioner Athletic Trainer Rolla, MO

Practice location

Address: 1000 W 10th St, Rolla, MO 65401-2905
Phone: (573) 230-6703
Mailing address: 1701 Ashwood Dr Apartment 7, Rolla, MO 65401-4691

Registered specialties

Athletic Trainer Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 2255A2300X Licence 2005012267 (MO)

Other Specialist/Technologist providers in Missouri →

Registry record

NPI: 1619910742
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Jun 2006
Record last updated: 13 Jul 2026

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.