| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JACOB WOOLLEY | 1689311326 | 2022-05-15 |
Jacob Woolley is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1689311326. Registration indicates Jacob Woolley is a provider of services with a specialization in Respiratory, Developmental, Rehabilitative and Restorative Service Providers, Specialist/Technologist (Specialist/Technologist: Athletic Trainer, ) (All Other Specialties & Provider Types, ) (Specialist/Technologist Athletic Trainer, Respiratory, Developmental, Rehabilitative and Restorative Service Providers) (Specialist/Technologist, )
| Entity Type | Individual |
| Provider Name | Jacob Woolley |
| Practice Office Address | 4043 CHATSWORTH ST N UNIT 449 SHOREVIEW, MN US |
| Practice Office Telephone | 8178086638 |
| Mailing Address | 4043 CHATSWORTH ST N UNIT 449 SHOREVIEW, MN 551265502 US |
| Business Telephone | 8178086638 |
| Code | Practice | License No State |
|---|---|---|
| 2255A2300X PRIMARY | Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist Specialist/Technologist: Athletic Trainer All Other Specialties & Provider Types Specialist/Technologist Athletic Trainer Respiratory, Developmental, Rehabilitative and Restorative Service Providers Specialist/Technologist |