National Provider Identifier

Jason Wentworth, ATC, CSCS

Jason Wentworth, ATC, CSCS is listed in the NPPES registry with a primary specialty of Athletic Trainer in Brockport, NY and a listed phone number of (585) 637-5303.

NPI 1689173932Brockport, NYAthletic Trainer

Profile Overview

NPI
1689173932
Provider Type
Individual
Primary Specialty
Athletic Trainer
Enumeration Date
February 01, 2018
Last Updated
February 01, 2018

Practice Location

  • 40 Allen St
  • Brockport, NY 14420

Phone: (585) 637-5303

Mailing Address

  • 40 Allen St
  • Brockport, NY 14420-2228

Specialties

  • Athletic Trainer (2255A2300X)
Full Record
NPI
1689173932
Entity Type
Individual
Last Name
Wentworth
First Name
Jason
Credential
ATC, CSCS
Mailing Street Address
40 Allen St
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-2228
Mailing Country
US
Practice Street Address
40 Allen St
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420
Practice Country
US
Practice Phone
(585) 637-5303
Enumeration Date
February 01, 2018
Last Updated
February 01, 2018
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Athletic Trainer (2255A2300X)