Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack Bixler

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1114568052

Jack Bixler is a Student in an Organized Health Care Education/Training Program in Philadelphia, Pennsylvania. Practices as a sole proprietor and works from 2 locations. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

9601 Germantown Ave
Philadelphia, PA 19118-2693
Phone: (484) 667-9540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 263 Alden St, Springfield, MA 01109-3707 — (484) 667-9540

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence RT007755 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1114568052
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 2, 2019
Last updated in NPPESSeptember 23, 2021
Certification dateSeptember 23, 2021

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