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1912568320
JACOB JOHNSON
DEARBORN, MI
NPI
1912568320
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-06-26
Last Update Date
2023-11-27
Business Address
JACOB JOHNSON
116 ELMWOOD ST
DEARBORN, MI 48124-1424
Phone number: 313-506-7374
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Mailing Address
JACOB JOHNSON
116 ELMWOOD ST
DEARBORN, MI 48124-1424
Phone number: 313-506-7374
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