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1922635093
BRIANNE JACOBSON
DETROIT, MI
NPI
1922635093
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MI 2601002314)
Enumeration Date
2020-03-26
Last Update Date
2020-03-26
Business Address
BRIANNE JACOBSON ATC, LAT
4001 W MCNICHOLS RD
DETROIT, MI 48221-3038
Phone number: 435-659-0849
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Mailing Address
BRIANNE JACOBSON ATC, LAT
1776 PARK AVE STE 4403
PARK CITY, UT 84060-5148
Phone number: 435-659-0849
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