Jackson Spencer

Athletic Trainer · Moscow, ID

Individual Active NPI

NPI number 1306379169

Practice location

627 Kenneth St
Moscow, ID 83843-3904
Phone
(208) 310-3255

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NPI record

NPI
1306379169
Entity type
Individual (Type 1)
Enumeration date
April 9, 2017
Last updated
April 9, 2017
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Athletic Trainer Primary 2255A2300X — —

About Jackson Spencer

Jackson Spencer is a healthcare provider registered in the NPI registry with the primary taxonomy Athletic Trainer (code 2255A2300X). The practice location is 627 Kenneth St, Moscow, ID 83843-3904. The NPI number 1306379169 was assigned on April 9, 2017 and the record was last updated on April 9, 2017.

Frequently asked questions

What is the NPI number of Jackson Spencer?

The NPI number is 1306379169.

What is the phone number of Jackson Spencer?

The phone number listed for the practice location is (208) 310-3255.

Where is Jackson Spencer located?

627 Kenneth St, Moscow, ID 83843-3904.

What is the taxonomy code for Jackson Spencer?

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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