Jack Douglas Stemm
Specialist/Technologist, Athletic Trainer in Jacksonville, FL. Individual provider (NPI-1).
NPI number1003661075
StatusActive
Last updated in NPPESApr 22, 2024
Details
- NPI
- 1003661075
- Entity type
- Individual (NPI-1)
- Name
- Jack Douglas Stemm
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 22, 2024
- Certification date
- Apr 22, 2024
- Last updated
- Apr 22, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AL7131 | FL | Yes |
Practice location
1 Performance PlJacksonville, FL 32202-1809
Phone 405-612-2671
Mailing address
10667 Brightman Blvd Apt 4304Jacksonville, FL 32246-7519
Phone 405-612-2671
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