Jackson Spencer
Jackson Spencer is an Athletic Trainer in Moscow, Idaho. Practices as a sole proprietor. Registered with an NPI since 2017.
- In the registry since
- 2017
Practice location Address checks out
627 Kenneth StMoscow, ID 83843-3904
Phone: (208) 310-3255
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Athletic Trainer (primary) | Taxonomy 2255A2300X |
|---|
Record details
| NPI number | 1306379169 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | April 9, 2017 |
| Last updated in NPPES | April 9, 2017 |
| Mailing address | 627 Kenneth St, Moscow, ID 83843-3904 |
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