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1609448323
RYAN MICHAEL JACOB
EDMOND, OK
NPI
1609448323
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist Athletic Trainer
Enumeration Date
2021-07-13
Last Update Date
2021-07-13
Business Address
RYAN MICHAEL JACOB
100 N UNIVERSITY DR
EDMOND, OK 73034-5207
Phone number: 405-974-2727
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Mailing Address
RYAN MICHAEL JACOB
12221 S LAND AVE
OKLAHOMA CITY, OK 73170-4509
Phone number: 405-837-2895
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