Jacob Earl Clark, MS, AT, NR-EMT

Athletic Trainer · Blissfield, MI

Individual Active NPI

NPI number 1093206773

Practice location

116 S Lane St
Blissfield, MI 49228-1206
Phone
(517) 486-5278

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NPI record

NPI
1093206773
Entity type
Individual (Type 1)
Enumeration date
May 29, 2018
Last updated
October 4, 2019
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X — —

Mailing address

3503 Willow Brook Ln
Toledo, OH 43611-3018
Phone
(419) 906-5086

Other practice locations (1)

  • D232 County Road 18, Holgate, OH 43527-9796 · (419) 906-5086

About Jacob Clark

Jacob Earl Clark, MS, AT, NR-EMT is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 116 S Lane St, Blissfield, MI 49228-1206. The NPI number 1093206773 was assigned on May 29, 2018 and the record was last updated on October 4, 2019.

Frequently asked questions

What is the NPI number of Jacob Earl Clark, MS, AT, NR-EMT?

The NPI number is 1093206773.

What is the phone number of Jacob Clark?

The phone number listed for the practice location is (517) 486-5278.

Where is Jacob Clark located?

116 S Lane St, Blissfield, MI 49228-1206.

What is the taxonomy code for Jacob Clark?

The primary taxonomy code is 2255A2300X – Athletic Trainer.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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