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

Jacob Casebolt, AT

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1184162836

Jacob Casebolt, AT is a Student in an Organized Health Care Education/Training Program in Pocatello, Idaho. Works from 2 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2017
Specialties on file
2

Practice location Address checks out

109 Taft Ave
Pocatello, ID 83201-5108
Phone: (208) 705-5038
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1307 E Broadway St., Missoula, MT 59801 — (406) 207-3045

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence AT-672 (ID)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1184162836
Entity typeIndividual (Type 1)
GenderMale
Credentials AT
Sole proprietorNo
NPI enumeratedFebruary 2, 2017
Last updated in NPPESJuly 12, 2019
Mailing address109 Taft Ave, Pocatello, ID 83201-5108

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