Individual provider · Type 1 NPI
Jacolby Thomas Whitaker
Student in an Organized Health Care Education/Training Program · Alto, TX
NPI number
1164054482
Active
Practice location
8830 State Highway 21
Alto, TX 75925-6018
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1164054482
Jacolby Thomas Whitaker's National Provider Identifier is 1164054482, issued on Feb 5, 2020. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Alto, TX. The record was last updated on Feb 5, 2020.