Jason Wentworth, ATC, CSCS
Specialist/Technologist, Athletic Trainer in Brockport, NY. Individual provider (NPI-1).
NPI number1689173932
StatusActive
Last updated in NPPESFeb 1, 2018
Details
- NPI
- 1689173932
- Entity type
- Individual (NPI-1)
- Name
- Jason Wentworth
- Credential
- ATC, CSCS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Feb 1, 2018
- Last updated
- Feb 1, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – | Yes |
Practice location
40 Allen StBrockport, NY 14420
Phone 585-637-5303
Mailing address
40 Allen StBrockport, NY 14420-2228
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